Benefits from an uncertainty management intervention for African–American and Caucasian older long‐term breast cancer survivors

Abstract

In a randomized controlled design, this study tested the efficacy of a theoretically based uncertainty management intervention delivered to older long-term breast cancer survivors. The sample included 509 recurrence-free women (360 Caucasian, 149 African-American women) with a mean age of 64 years (S.D.=8.9 years) who were 5-9 years post-treated for breast cancer. Women were randomly assigned to either the intervention or usual care control condition. The intervention was delivered during four weekly telephone sessions, in which study nurses guided cancer survivors in the use of audiotaped cognitive-behavioral strategies to manage uncertainty about recurrence, and a self-help manual designed to help women understand and manage long-term treatment side effects and other symptoms. Treatment outcome data on uncertainty management were gathered at pre-intervention and 10-months afterward. Repeated measures MANOVA evaluating treatment group, ethnic group, and treatment by ethnic interaction effects indicated that training in uncertainty management resulted in improvements in cognitive reframing, cancer knowledge, patient-health care provider communication, and a variety of coping skills. Results are discussed in terms of the importance of theory-based interventions for cancer survivors that target triggers of uncertainty about recurrence and in terms of ethnic differences in response to the intervention.

The Future as a Series of Transitions: Qualitative Study of Heart Failure Patients and Their Informal Caregivers

“…Studies have identified that, as positive adjustment to health status occurs, tolerance for uncertainty can increase, reducing fear and emphasizing living life to the fullest now. [27][28][29] Because transitions facilitated re-framing and adjustment to the reality of illness, supporting patients and caregivers through this process might help to strengthen relationships, redefine roles, and reconstruct self-identity. 22 In addition, helping patients and caregivers understand transitions as a potential for anticipating new beginnings, such as a new phase of living with their illness, in addition to grieving and coming to terms with endings, may facilitate "transition agility," the ability to make transitions throughout the illness trajectory with minimal distress.…”

Effectiveness of a Multidisciplinary Intervention in Breast Cancer Survivors

“…No entanto, alguns estudos têm indicado a possibilidade da sua eficácia (Mishel et al, 2005). Apesar desta indicação de melhoria o mesmo estudo também salienta que embora os pensamentos automáticos de possibilidade de reincidência não surjam constantemente nas sobreviventes, a ameaça de reincidência dificilmente é descartada (Mishel et al, 2005).…”

“…As intervenções psicossociais têm tido um contributo positivo no ajustamento emocional e funcional das pacientes com cancro da mama (Antoni et al, 2001). Vários estudos têm demonstrado a eficácia da terapia cognitivo-comportamental (e.g., Goedendorp, Knoop, Gielissen, Verhagen, & Bleijenberg, 2014) e da psicoeducação nomeadamente: na redução de sintomas depressivos (Barsevick, Sweeney, Haney, & Chung, 2002); no aumento do conhecimento sobre a doença e tratamentos (Okamura, Fukui, Nagasaka, Koike, & Uchitome, 2003); na minimização do distress e ansiedade (Trask, Paterson, Griffith, Riba, & Schwartz, 2003); no 485 www.sp-ps.pt aumento da perceção de autoeficácia (Pereira, Lima, Monteiro, Torres, & Caetano, 2014); na limitação das possibilidades de reincidência (Mishel et al, 2005); na utilização de estratégias de coping adaptativas (Souza & Araújo, 2010); e na melhoria da qualidade de vida (QdV) (Trask, Paterson, Griffith, Riba, & Schwartz, 2003). A intervenção psicológica realizada no formato de grupo tem sido a mais utilizada nos indivíduos com cancro sendo a sua eficácia comprovada na literatura (Venâncio, 2004).…”

Reminiscence Cognitive Behavior Therapy for Spiritual Well-Being and Self-Esteem of Cancer Patients

“…Regarding the CBT techniques, there are many different and useful techniques in CBT. Mishel et al [5] used cognitive reframing, cancer knowledge, communication and various coping skills, whereas Puentes [14] used correction of distortion of thinking and Penedo et al [20] used deep-breathing, guided imagery, and progressive muscle relaxation for patients. In the present study, we used emotional expression, problem-solving, distraction, daily scheduling, and psychological education.…”

“…However, this efficacy was shown for patients with symptoms and psychological problems or states that are likely to differ from those in patients undergoing treatment who are not terminally ill. Patients under treatment commonly have psychological distress, life anxiety, and depression or uncertainty [5], resulting in low self-esteem.…”