Benefits of the uncertainty management intervention for African American and white older breast cancer survivors: 20-Month Outcomes

Abstract

In a 2 x 2 randomized block repeated measure design, this study evaluated the follow-up efficacy of the uncertainty management intervention at 20 months. The sample included 483 recurrence-free women (342 White, 141 African American women; mean age = 64 years) who were 5-9 years posttreatment for breast cancer. Women were randomly assigned to either the intervention or usual care control condition. The intervention was delivered during 4 weekly telephone sessions in which survivors were guided in the use of audiotaped cognitive-behavioral strategies and a self-help manual. Repeated measures MANOVAs evaluating treatment group, ethnic group, and treatment by ethnic interaction effects at 20 months indicated that training in uncertainty management resulted in improvements in cognitive reframing, cancer knowledge, and a variety of coping skills. Importantly, the 20-month outcomes also demonstrated benefits for women in the intervention condition in terms of declines in illness uncertainty and stable effects in personal growth over time.

Breast and ovarian cancer survivors' experience of participating in a cognitive-existential group intervention addressing fear of cancer recurrence

“…This technique could also be combined with affirmations, which are self-talk phrases that help to control and decrease negative or intrusive thoughts by learning calming and comforting words or sentences such as saying "I am afraid my cancer will come back but this feeling of uncertainty is only temporary. I am in control" (Gil and et al, 2006). These affirmations were previously used in an uncertainty management intervention for women with breast cancer (Gil and et al, 2006).…”

“…Our intervention was also guided by the Leventhal's Common Sense Model (Lee-Jones and et al, 1997) and Mishel's Uncertainty in Illness Theory (Mishel, 1988). Our group approach included teaching coping strategies such as cognitive reframing and relaxation (Gil and et al, 2006;Mishel and et al, 2005) to manage the accompanying distress associated with FCR. A visit by a nurse specialist in either breast or ovarian cancer also provided an educational 45-min presentation on the possible signs and symptoms of cancer recurrence; this visit occurred in session 2.…”

“…Returning to the treatment site is known to possibly trigger FCR (Gil and et al, 2006). As one woman told us:…”

“…I am in control" (Gil and et al, 2006). These affirmations were previously used in an uncertainty management intervention for women with breast cancer (Gil and et al, 2006). The women were also encouraged to formulate some of their own affirmative self-talk phrases.…”

Relationship between Uncertainty and Emotions in Advanced Lung Cancer Patients after Initial Therapy

“…This was because their strong uncertainty greatly affected their emotions. Studies on support systems that allow individuals to manage uncertainty on their own are available for patients with other cancers (20) ; a similar study for advanced lung cancer patients is needed. Support systems of the uncertainty management could help maintain and improve the QOL of patients by allowing them to control their emotions and to move forward as survivors living with cancer.…”