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Individual psychosocial support for breast cancer patients: A randomized study of nurse vs. psychologist interventions and standard care
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
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2007 (English)In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 30, no 3, E10-E19 p.Article in journal (Refereed) Published
Abstract [en]

In a prospective, randomized study, an individual psychosocial support intervention performed by specially trained oncology nurses, or psychologists, were compared with standard care. Consecutive primary breast cancer patients about to start adjuvant therapy (n = 179) were included. Data were supplied by the questionnaires European Organisation for Research and Treatment of Cancer Quality of Life Study Group Core Quality of life questionnaire with 30 questions (EORTC QLQ-C30) and Breast Cancer Module with 23 questions (BR23), the Hospital Anxiety and Depression Scale, Spielberger's State-Trait Anxiety Inventory, and the Impact of Event Scale before randomization and 1, 3, and 6 months later. Patient files provided data on utilization of psychosocial support offered in routine care. Global quality of life/health status, nausea and vomiting, and systemic therapy side effects were the subscales showing significant Group by Time interactions, favoring the interventions. Intervention groups improved statistically significantly more than the standard care group regarding insomnia, dyspnea, and financial difficulties. Nurse patients experienced less intrusion compared with the standard care group. All groups showed statistically and clinically significant improvements with time on several subscales. The intervention groups, however, improved to a greater extent. Fewer patients in the intervention groups used psychosocial hospital support compared with the standard care group. In conclusion, psychosocial support by specially trained nurses using techniques derived from cognitive behavioral therapy is beneficial for breast cancer patients and may be a realistic alternative in routine cancer care.

Place, publisher, year, edition, pages
2007. Vol. 30, no 3, E10-E19 p.
Keyword [en]
Breast cancer patients, Individual psychosocial support, Intervention study, Randomized
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-96017DOI: 10.1097/01.NCC.0000270709.64790.05OAI: oai:DiVA.org:uu-96017DiVA: diva2:170423
Available from: 2007-05-24 Created: 2007-05-24 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Individual psychosocial support for breast cancer patients: Quality of life, psychological effects, patient satisfaction, health care utilization and costs
Open this publication in new window or tab >>Individual psychosocial support for breast cancer patients: Quality of life, psychological effects, patient satisfaction, health care utilization and costs
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A randomized intervention study, with the aim to compare the effects of individual psychosocial support provided by (1) oncology nurses specially trained in psychological techniques (INS), or (2) psychologists (IPS), to (3) standard care (SC). Breast cancer patients, living in Uppsala County, and about to start adjuvant treatment at the Department of Oncology, Uppsala, were consecutively included between 1998 and 2000. The patients were assessed seven times during two years by self-administered questionnaires. Study I revealed positive effects of both INS and IPS as compared to SC on global quality of life, side effects, and post-traumatic distress. A lower proportion of patients in the intervention groups had psychosocial support provided in routine care compared with the SC group. In study II the patients reported being highly satisfied with the intervention, irrespective of profession providing the support. However, patients in the INS group reported higher levels of benefit regarding disease-related problems than those in the IPS group. In study III total Health Care costs were lower in the intervention groups and since a gain in quality-adjusted life years (QALY) was seen (mean .1 QALY), the interventions dominated. The costs for the interventions were 44 291- 48 978 SEK. In study IV, daily reporting of anxiety, depression and activity on Visual Analogue Scales (VAS) were completed during two weeks before and after the Hospital Anxiety and Depression Scale (HADS) assessments. A point assessment with the HADS captured the situation better than four weeks assessment on three VAS in the diary. The HADS was considered preferable to the diary. The conclusion is that psychosocial support is beneficial for breast cancer patients and that the intervention delivered by nurses was as effective as that given by psychologists. The costs for the interventions were limited.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 73 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 268
Keyword
Oncology nursing, Breast cancer patients, Individual psychosocial support, Intervention study, Randomized, Quality of life, Psychological effects, Patient satisfaction, Health care utilization and costs, Onkologisk vård
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-7929 (URN)978-91-554-6922-1 (ISBN)
Public defence
2007-09-07, Auditorium Minus, Gustavianum, Uppsala, 09:00
Opponent
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Available from: 2007-05-24 Created: 2007-05-24 Last updated: 2013-08-29Bibliographically approved

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Arving, CeciliaJohansson, Birgitta

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