There are three purposes to the current study: (1) to test the effectiveness of a home visitation program for child-rearing families experiencing non-metastatic breast cancer in the mother; (2) to test a causal model of nurses' coaching behavior underlying the intervention;and (3) to test the cost- effectiveness of the intervention. The therapeutic goal of the intervention is to facilitate the family's management of the mother's illness and to minimize disruption to household members and their psychosocial functioning. Results from the study will reveal whether psychosocial morbidity in the household can be lowered by a visitation program in the homes of a child-rearing couple compared to controls. An experimental design will be used with random assignment:the Experimental Group will receive three home visits at one-month intervals; the Control Group will receive """"""""treatment as usual"""""""" from their physicians and clinic nurses. Both groups will be measured on the criterion measures at four occasions: at pretest, after three months into the study, and at three and six months follow-up. It is hypothesized that the mothers and their partners in the Experimental Group compared to the Control Group will experience fewer illness demands, lower levels of depression, higher levels of marital adjustment, higher levels of emotional and physical accessibility to their children, more frequently use introspective coping behavior, and will report higher levels of family functioning. Children in the Experimental Group will experience lower anxiety, and higher levels of social and behavioral adjustment than children in the Control Group. Results will ultimately enable nurse scientists to develop coaching programs with families experiencing other types of life threatening, chronic illness in the mother, e.g., insulin dependent diabetes, multiple sclerosis, and kidney disease.

National Institute of Health (NIH)
National Cancer Institute (NCI)
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Nursing Research Study Section (NURS)
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University of Washington
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Schools of Nursing
United States
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Zahlis, Ellen H; Lewis, Frances M (2010) Coming to grips with breast cancer: the spouse's experience with his wife's first six months. J Psychosoc Oncol 28:79-97
Fletcher, Kristin A; Lewis, Frances Marcus; Haberman, Mel R (2010) Cancer-related concerns of spouses of women with breast cancer. Psychooncology 19:1094-101
Lewis, Frances Marcus; Fletcher, Kristin A; Cochrane, Barbara B et al. (2008) Predictors of depressed mood in spouses of women with breast cancer. J Clin Oncol 26:1289-95
Lewis, Frances Marcus (2006) The effects of cancer survivorship on families and caregivers. More research is needed on long-term survivors. Am J Nurs 106:20-5
Shands, Mary Ellen; Lewis, Frances Marcus; Sinsheimer, Janet et al. (2006) Core concerns of couples living with early stage breast cancer. Psychooncology 15:1055-64
Lewis, Frances Marcus (2004) Shifting perspectives: family-focused oncology nursing Research. Oncol Nurs Forum 31:288-92
Lewis, F M (1998) Family-level services in oncology nursing: facts, fallacies, and realities revisited. Oncol Nurs Forum 25:1378-88
Motzer, S A; Moseley, J R; Lewis, F M (1997) Recruitment and retention of families in clinical trials with longitudinal designs. West J Nurs Res 19:314-33
Lewis, F M; Zahlis, E H (1997) The nurse as coach: a conceptual framework for clinical practice. Oncol Nurs Forum 24:1695-702
Lewis, F M (1997) Behavioral research to enhance adjustment and quality of life among adults with cancer. Prev Med 26:S19-29

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