Stress associated with a life threatening illness contributes to poor adjustment and psychological and physiological consequences harmful to recovery. Cancer and its treatment are associated with considerable distress, impaired quality of life, poor mental health, and reduced physical function, which is particularly true for women with breast cancer undergoing chemotherapy treatment. Psycho-oncology research has provided a strong foundation for the benefits of psychosocial and psychoeducational intervention at improving quality of life and mental health in cancer patients. Recently, palm-size personal computers (PPC) have been used for psychological assessment and delivery of cognitive-behavioral therapy, and the findings suggest that computer-assisted interventions may enhance the effectiveness of more traditional psychoeducational programs for cancer patients. The proposed project will develop, pilot-test examine the feasibility of a palm-size personal computer assisted cognitive-behavioral stress management (PPC-CBSM) program for women with breast cancer. In Part I, we will conduct focus groups and intensive interviews to determine the most common cognitive distortions, the most prevalent cancer-related stressors, and specific strategies for coping with different cancer-related stressors. In Part II, we will examine the different coping strategies for specific cancer-related stressors using ecological momentary assessment techniques with the PPCs. The information from Parts I and II will be used to refine the final PPC program and to individually tailor the program to provide patients with preferred situation-specific coping strategies. In Part III, we will be recruited and initial measures obtained during the week before the administration of the first cycle of chemotherapy. Women will be randomly assigned to a PPC-CBSM group (which will receive six sessions of CBSM supplemented with the PPC) or to a traditional CBSM group (which will receive six sessions of CBSM). Patients will be assessed at three other time points: at the end of the six sessions of CBSM, 1 week before the fourth cycle of chemotherapy, and 6 months after the end of the interventions. We hypothesize that the use of this new innovative technology will help increase the efficacy of traditional psychosocial interventions by increasing the use of adaptive coping strategies and the frequency of practice of the stress management skills through providing coping strategies that can be accessed in """"""""real time"""""""" when they are needed to help manage side effects of treatment and promote faster recovery.
|Ratcliff, Chelsea G; Lam, Cho Y; Arun, Banu et al. (2014) Ecological momentary assessment of sleep, symptoms, and mood during chemotherapy for breast cancer. Psychooncology 23:1220-8|