Effect of a Cognitive Behavioral Intervention on Reducing Symptom Severity During Chemotherapy

Given, Charles W.; Given, Barbara; Rahbar, Mohammad Hossein; Jeon, Sangchoon; McCorkle, Ruth; Cimprich, Bernadine; Gałecki, Andrzej T.; Kozachik, Sharon; Brady, Albert M.; Fisher-Malloy, Mary Jo; Courtney, Kathy; Bowie, Elizabeth

doi:10.1200/jco.2004.01.241

Cited by 160 publications

(159 citation statements)

References 47 publications

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“…Previous studies using combined symptom severity scores as the outcome measure were not suited to multivariate testing and unable to identify the effect of the intervention on individual symptoms. 8,15 The current study is one of the few PEI studies conducted in an Asian population with cancer. As evidenced by patients' lack of previous experience in using psychosocial orientated interventions and conclusions drawn from previous reviews; 32,38,39 the application of PEI in this context can be considered novel.…”

Section: Discussionmentioning

confidence: 99%

“…4,6,15,28 Development of the PEI in this study was informed by previous research on breathlessness, fatigue and anxiety in cancer patients 4,6,29 and the literature on PEIs. PEI alters patients' perception and sensation of symptoms through stress reduction; clarification of misconception; and the adoption of adaptive behaviors.…”

Section: Interventionmentioning

confidence: 99%

“…Given et al's 8 study demonstrated the 'value-added' role of a psychoeducational intervention (PEI) in reducing overall symptom burden of 12 common symptoms. In 2004, Given et al 15 conducted a similar study demonstrating the positive effect of a PEI on 15 symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…6,8,15 In the last few decades, large numbers of studies evaluating PEI in patients with cancer have been conducted. 12 Progressive muscle relaxation (PMR) appears to be the most prevalent intervention to be studied, followed by patient education.…”

Section: Introductionmentioning

confidence: 99%

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Managing Symptoms in Patients with Advanced Lung Cancer During Radiotherapy: Results of a Psychoeducational Randomized Controlled Trial

Chan

Richardson

2011

Journal of Pain and Symptom Management

122

114

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(250 words)Context: Breathlessness, fatigue, and anxiety are distressing symptoms for patients with advanced lung cancer. Usually managed as isolated symptoms, they can often occur simultaneously. Previous research has often addressed management of discrete symptoms rather than considering them as a cluster, which in reality is the situation faced by patients.Objectives: This study aims to examine the effectiveness of a psychoeducational intervention (PEI) on the symptom cluster of anxiety, breathlessness and fatigue, compared with usual care. Methods:A pre-test post-test 2-group randomized controlled trial was conducted.Education on symptom management and coaching in the use of progressive muscle relaxation were delivered to patients one week prior to commencing radiotherapy (RT), and repeated 3 weeks after the first. Symptom data were collected at 4 time points: prior to the intervention, 3 weeks, 6 weeks, and 12 weeks post intervention.Results: 140 lung cancer patients receiving palliative RT were recruited from a public funded hospital in Hong Kong. Doubly multivariate MANOVA revealed a significant difference (Time *group interaction effect, p = .003) over time between the PEI and usual care control group on the pattern of change of the symptom cluster. Significant effects on the patterns of changes in breathlessness (p = .002), fatigue (p = .011), anxiety (p = .001) and functional ability (p = .000) were also found. 4Conclusions: PEI was a promising treatment for relieving the symptom cluster and each of the individually assessed symptoms. More effort needs to be directed at studying impact of interventions on common symptom clusters.

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Section: Discussionmentioning

confidence: 99%

Section: Interventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Managing Symptoms in Patients with Advanced Lung Cancer During Radiotherapy: Results of a Psychoeducational Randomized Controlled Trial

Chan

Richardson

2011

Journal of Pain and Symptom Management

122

114

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“…Seven randomised clinical trials to evaluate supportive interventions (group and individual), education and stress management groups, coping strategies training and behavioural interventions to assist patients with managing their fatigue have been published with impressive results. Given et al (2004) conducted a randomised clinical trial to evaluate a cognitive behavioural intervention to reduce cancer-related symptom burden. The investigators found that a 20-week (10 contacts) cognitive behavioural intervention demonstrated significant impact on severity of cancer-related symptoms after four contacts (10 weeks), and this reduction was maintained at 20 weeks among those patients who entered the trial with moderate to severe symptoms.…”

Section: Interventions For Cancer-related Fatiguementioning

confidence: 99%

Fatigue and cancer: causes, prevalence and treatment approaches

2004

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Fatigue is the most prevalent cancer-related symptom and has a significant adverse impact on patients' functional ability and quality of life. Hypotheses regarding the aetiology of cancer-related fatigue are discussed, and clinical practice guidelines for the evaluation and management of oncology patients with fatigue are reviewed. Both nonpharmacologic and pharmacologic strategies for the management of fatigue are summarised.

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Effect of Telecare Management on Pain and Depression in Patients With Cancer

Kroenke

Theobald

et al. 2010

JAMA

291

306

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Context Pain and depression are two of the most prevalent and treatable cancer-related symptoms, yet frequently go unrecognized and/or undertreated. Objective To determine whether centralized telephone-based care management coupled with automated symptom monitoring can improve depression and pain in cancer patients. Design, Setting, and Patients Randomized controlled trial conducted in 16 community-based urban and rural oncology practices across the state of Indiana. Recruitment occurred from March 2006 through August 2008 and follow-up concluded in August 2009. The 405 patients had depression (Patient Health Questionnaire-9 score ≥ 10), cancer-related pain (Brief Pain Inventory worst pain score ≥ 6), or both. Intervention Patients were randomly assigned to the intervention (n=202) or to usual care (n=203), stratified by symptom type. Intervention patients received centralized telecare management by a nurse-physician specialist team coupled with automated home-based symptom monitoring by interactive voice recording or internet. Main Outcome Measures Blinded assessment at baseline, 1, 3, 6, and 12 months for depression (20-item Hopkins Symptom Checklist [HSCL-20]) and pain (Brief Pain Inventory [BPI]) severity. Results There were 131 patients enrolled with depression only, 96 with pain only, and 178 with both depression and pain. Of the 274 patients enrolled for pain, the 137 intervention patients had greater improvements than the 137 usual care patients in BPI pain severity over the 12 months of the trial whether measured as a continuous severity score or as a categorical pain responder (P < .0001 for both). Similarly, of the 309 patients enrolled for depression, the 154 intervention patients had greater improvements than the 155 usual care patients in HSCL-20 depression severity over the 12 months of the trial whether measured as a continuous severity score (P < .0001) or as a categorical depression responder (P < .001). The standardized effect size for between-group differences at 3 and 12 months was .67 and .39 for pain, and .42 and .44 for depression. Conclusion Centralized telecare management coupled with automated symptom monitoring resulted in improved pain and depression outcomes in cancer patients receiving care in geographically-dispersed urban and rural oncology practices.

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Effect of a Cognitive Behavioral Intervention on Reducing Symptom Severity During Chemotherapy

Cited by 160 publications

References 47 publications

Managing Symptoms in Patients with Advanced Lung Cancer During Radiotherapy: Results of a Psychoeducational Randomized Controlled Trial

Managing Symptoms in Patients with Advanced Lung Cancer During Radiotherapy: Results of a Psychoeducational Randomized Controlled Trial

Fatigue and cancer: causes, prevalence and treatment approaches

Effect of Telecare Management on Pain and Depression in Patients With Cancer

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