The proposed study extends a successful nursing intervention for breast cancer patients to how income elderly white and minority women. The intervention would teach these women uncertainty management as a means of enhancing self-card and self-help behaviors. The purposes of this study are: 1) to determine the effectiveness of an uncertainty management intervention delivered by a nurse-client manager via telephone in increasing cancer knowledge, enhancing self-care, promoting self-help response, and improving quality of life among older, low-income, white, African-American, and Mexican-American women receiving treatment for breast cancer: 2) to determine whether person factors (including functional status, co-morbidity, education, uncertainty, uncertainty management, and satisfaction with health care), disease factors (including type of medical treatment, number of types of treatments, recurrence, metastases, and staging), contextual factors (including sources of information, social support, place receiving treatment, and access to treatment) and time enhance or limit self-care/self-help activities, cancer knowledge and life quality of women during cancer treatment; and 3) to estimate the cost effectiveness of the intervention. The design is a 2 X 3 repeated measures design with two levels of treatment (uncertainty management and natural control condition) crossed with three levels of ethnicity (white, African-American, and Mexican- American). The measures are taken at baseline and 4 and 7 months post baseline. The intervention runs for 10 weeks and is delivered via weekly telephone calls. The intervention is based on the Uncertainty in Illness Theory (Mishel, 19880 and the research on the relationship between uncertainty and self-help (Braden, 19900 and has been enhanced specifically for the targeted population based on data from the initial intervention study with women receiving treatment for breast cancer. Multivariate models will be used to test for intervention effects, efficiency, pattern of change and durability of change over time relative to four outcomes, self-care, self-help, cancer knowledge and life quality. Multiple regression and general linear mixed models analyses will be used for testing mediator and moderator effects and interpreting the effect of time on the outcome variables. Analyses include testing both direct and interactive effects of groups of variables classified as person, disease, and contextual variables that have either a moderation or mediation effect on outcome variables. Cost effectiveness analytic techniques will be used to calculate ratios of change in the outcome measures achieved relative to costs and utilization level within the two subject groups.
| Hamilton, Jill B; Powe, Barbara D; Pollard 3rd, Alton B et al. (2007) Spirituality among African American cancer survivors: having a personal relationship with God. Cancer Nurs 30:309-16 |
| Hamilton, Jill B; Sandelowski, Margarete (2004) Types of social support in African Americans with cancer. Oncol Nurs Forum 31:792-800 |
| Harris, Lorna; Belyea, Michael; Mishel, Merele et al. (2003) Issues in revising research instruments for use with Southern populations. J Natl Black Nurses Assoc 14:44-50 |
| Hamilton, Jill B; Sandelowski, Margarete (2003) Living the golden rule: reciprocal exchanges among African Americans with cancer. Qual Health Res 13:656-74 |
