The proposed study refines a set of successful nursing interventions for women with breast cancer. The refinement will optimize the interventions' ability to teach the uncertainty management and enabling skills that enhance self-help and self-care behaviors and that aid maintenance of life quality. The refinement is guided by the principles of treatment theory. Treatment theory principles include: a problem definition that specifies what condition is treatable, for who, under what circumstances; a specification of what is sufficient and what is optimal to produce the desired results - the basis for judging magnitude or strength of the treatment; the important processes that treatment brings about along with crucial interactions with individual differences, timing, mode of delivery and a specification of expected treatment effects and side effects (Lipsey, 1990a). The purpose of this investigation is to develop a treatment theory that specifies which treatment activities within each SHIP intervention are found to be most beneficial in strengthening coping strategies and that identifies profiles of those most likely to use and benefit from each of the interventions.
The specific aims are to: 1) describe the treatment activities within the six two hour self-help classes, the six independent study lessons and the six week uncertainty management intervention that are most closely linked to uncertainty, enabling skill, a sense of mastery, self-care, self-help, psychological adjustment and life quality; 2) profile which characteristics of women receiving treatment for breast cancer are linked to complete or to partial participation in each of the interventions; 3) describe which contextual factors; such as, characteristics of women's medical treatment regimen for breast cancer, are linked to complete or to partial participation in each of the interventions; 4) to describe the cost effectiveness implications of partial versus full participation in each of the interventions alone or in combination.
