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A randomized controlled trial of a support group intervention on the quality of life and fatigue in women after primary treatment for early breast cancer
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Immune and Gene Therapy Laboratory,Cancer Centre,Karolinska,Karolinska University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Department of Medical Epidemiology and Biostatiststics.
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2012 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 20, no 12, 3325-3334 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

When diagnosed with breast cancer, most women's lives change as well as their perspectives on and appreciation of life. The aim of the present study was to evaluate whether psychosocial support intervention could influence health-related quality of life (HRQOL) and fatigue during the first year after diagnosis.

MATERIAL AND METHODS:

Of 382 patients with newly diagnosed breast cancer, 191 patients were randomized to an intervention group and 191 patients were randomized to a routine control group. The intervention group received support intervention that lasted 1 week on a residential basis, followed by 4 days of follow-up 2 months later. The support intervention included informative educational parts, relaxation training, mental visualization, and nonverbal communication. HRQOL was measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-BR23 questionnaires and fatigue with the Norwegian version of the fatigue scale at baseline and at 2, 6, and 12 months after intervention.

RESULT:

There was a time-dependent improvement in both functional and symptom scales between baseline and 12 months as measured by the EORTC QLQ-C30 and BR23 questionnaires and there was a decrease in fatigue between baseline and after 2 months with further improvement up to 12 months in both groups, but there were no differences between the intervention and control groups at any point in time.

CONCLUSION:

HRQOL improves and symptoms of fatigue decrease over time, but we could not see any additional effect from the rehabilitation program in this setting.

Place, publisher, year, edition, pages
2012. Vol. 20, no 12, 3325-3334 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-181545DOI: 10.1007/s00520-012-1480-1ISI: 000310232500038PubMedID: 22576981OAI: oai:DiVA.org:uu-181545DiVA: diva2:556645
Available from: 2012-09-25 Created: 2012-09-25 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Support Group Intervention in Primary Breast Cancer: Health-Related Quality of Life, with Special Reference to Anxiety, Depression and Fatigue
Open this publication in new window or tab >>Support Group Intervention in Primary Breast Cancer: Health-Related Quality of Life, with Special Reference to Anxiety, Depression and Fatigue
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to investigate in a (RCT) the effect of support group intervention in women with primary breast cancer in the short term, and with a long-term follow-up. Women with primary breast cancer were randomized between April 2002 and November 2007 and stratified according to adjuvant treatment with chemotherapy. Of 382 eligible patients, 191+191 patients were randomized to intervention and control groups respectively. Control patients were subjected to standard follow-up procedures. Patients in the intervention group received support intervention at the Foundation of Lustgården Mälardalen during one week followed by four days of follow-up two months later. Patients in intervention and control groups filled in questionnaires at baseline, after 2, 6 and 12 months and in the long-term follow-up after a mean of 6.5 years. In paper I, we studied the effect of the intervention on anxiety and depression measured by the HAD scale and we could show that a significantly lower proportion of women in the intervention group had high anxiety scores compared with women in the control group after 12 months; however, the proportion of women with high depression scores were unaffected. In paper II, we studied the effect of the intervention on fatigue and health-related quality of life (HRQoL) measured by the Norwegian version of the fatigue questionnaire (FQ) and EORTC-QLQ 30 and BR 23.We could not demonstrate any significant effect of the intervention. In paper III, we studied the effect of the intervention on sick-leave, healthcare utilization and the effect of the intervention in economic terms. We used a specially formulated questionnaire. There was a trend towards longer sick leave and more health-care utilization in the intervention group. The difference in total costs was statistically significantly higher in the intervention group after 12 months (p= 0.0036). In paper IV, we studied the long-term effects of the support intervention on anxiety, depression, fatigue and HRQoL. We could show a significant effect of the intervention on cognitive function, body image, future perspective and fatigue, the largest effect was seen among women who received chemotherapy; however, no effects on anxiety and depression were demonstrated.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 77 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 819
Keyword
Support group intervention, breast cancer, anxiety, depression, fatigue, health-related quality of life, sick-leave, health-care utilization
National Category
Clinical Medicine
Research subject
Oncology
Identifiers
urn:nbn:se:uu:diva-182083 (URN)978-91-554-8485-9 (ISBN)
Public defence
2012-11-17, Aulan, Ingång 21, Västmanlands sjukhus Västerås, Västerås, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-10-26 Created: 2012-10-03 Last updated: 2013-01-23Bibliographically approved

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Granstam Björneklett, HelenaOjutkangas, Marja-LeenaBergkvist, Leif

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