In the proposed randomized clinical trial (RCT), the effect of standardized education (SE) alone, telephone counseling (TC) alone, and standardized education with telephone counseling (SE+TC) on emotional, physical and social adjustment will be compared among patients with breast cancer and their partners. The findings from a preliminary study of 128 women and 121 partners from the diagnostic through the recovery phases (Hoskins, 1990-1994) provide the evidence for the interventions. The stress-coping model (Lazarus and Folkman, 1984) and crisis intervention model (Morely, Messick, & Aguilera, 1967) provide the theoretical framework. Components of the intervention, i.e., standardized education and telephone counseling, are designed to provide information essential to making decisions, managing medical factors related to treatment of the disease, developing coping skills, and cultivating social support. Medical factors are conceptualized as moderating variables; social support and coping skills will be examined as either mediating or moderating variables. Following biopsy report but within one week prior to surgery, patients and partners who meet inclusion criteria (n=280 dyads) complete a set of five questionnaires to assess initial levels of the study variables. Participants are randomly assigned to one of four groups. Patients in the control condition receive the currently accepted disease management protocol (DM) in a hospital-based surgical oncology service, which all groups receive. Patients and partners in Group two receive DM plus a series of four phase-specific standardized educational videotapes (SE); Group three receives DM plus four phase-specific telephone counseling sessions (DM+TC); Group four (DM+SE+TC), receives disease management combined with both standardized education and telephone counseling. All groups receive assessment of adjustment outcomes by the set of questionnaires at the four phases. A pilot study (1-R15-NR04967-0l) supports the feasibility of a RCT. The primary hypothesis is that mean changes in emotional adjustment (measured by the PAL-C Psychological Well-being score for patients and for partners, and BCTRI side effects distress score for patients); physical adjustment (measured by SRHS Better Health and No Problems sub-scales for patients and for partners. the PAL-C Physical Symptoms score for partners, and the BCTRI side effects intensity score for patients); and social adjustment (measured by the sum of the PAIS Domestic, Social, and Vocational Role function scores for patients and partners) will differ in both patients and partners among the four groups. Emotional, physical and social adjustments are expected to be greater in each of the study interventions vs. DM and greater in DM+SE+TC as compared to DM+SE or DM+TC.
| Sherman, Deborah Witt; Haber, Judith; Hoskins, Carol Noll et al. (2012) The effects of psychoeducation and telephone counseling on the adjustment of women with early-stage breast cancer. Appl Nurs Res 25:3-16 |
| Sherman, Deborah Witt; Haber, Judith; Hoskins, Carol Noll et al. (2009) Differences in physical, emotional, and social adjustment of intimate, family, and nonfamily patient-partner dyads based on a breast cancer intervention study. Oncol Nurs Forum 36:E185-97 |
| Budin, Wendy C; Hoskins, Carol Noll; Haber, Judith et al. (2008) Breast cancer: education, counseling, and adjustment among patients and partners: a randomized clinical trial. Nurs Res 57:199-213 |
