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.
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