The goal of this research is to implement a counseling intervention to enhance quality of life and increase compliance among women with breast cancer who are medically thought to have a good prognosis. A second goal of the research is to determine the mechanisms by which such an intervention affects quality of life and compliance. A third goal of the research is to identify patients who are most likely to benefit from one particular kind of intervention. A final goal of the research is to evaluate the costs and cost-effectiveness of the interventions. The interventions in this research will address two psychosocial tissues that are central to adjustment to breast cancer: perceived control and self- esteem. Women with Stage I and II breast cancer who undergo surgery and are treated with adjuvant chemotherapy will be eligible to participate. Medical oncologists from three different sites will identify eligible patients and refer them to the study. Patients will be randomly assigned to one of four groups just prior to or during the first weeks of chemotherapy. The first group will have an educational focus and be patterned after the American Cancer Society's I CAN COPE program. The mechanism that this intervention will focus on is perceived control, manipulated by giving information and teaching cognitive/behavioral techniques (progressive relaxation training, visualization, and emotion regulation). The second group will be more traditional peer support group. The mechanism that this intervention will focus on is the restoration of self-esteem. It will involve the sharing of experiences, social comparison, and altruism. The third group will be a combination of the two and the fourth group will be usual care. Groups 1, 2, and 3 will meet weekly for a period of 8 sessions, each session ranging between 60 and 120 minutes. Quality of life will be measured before the intervention, immediately after the intervention, 6 months after the intervention and then yearly for five years. Adherence to treatment and long-term follow-up will be assessed over the same period of time.
| Cohen, Sheldon (2004) Social relationships and health. Am Psychol 59:676-84 |
| Helgeson, V S; Cohen, S; Schulz, R et al. (2001) Long-term effects of educational and peer discussion group interventions on adjustment to breast cancer. Health Psychol 20:387-92 |
| Helgeson, V S; Cohen, S; Schulz, R et al. (2000) Group support interventions for women with breast cancer: who benefits from what? Health Psychol 19:107-14 |
| Helgeson, V S; Cohen, S; Schulz, R et al. (1999) Education and peer discussion group interventions and adjustment to breast cancer. Arch Gen Psychiatry 56:340-7 |
| Schulz, R; Bookwala, J; Knapp, J E et al. (1996) Pessimism, age, and cancer mortality. Psychol Aging 11:304-9 |
| Helgeson, V S; Cohen, S (1996) Social support and adjustment to cancer: reconciling descriptive, correlational, and intervention research. Health Psychol 15:135-48 |
