Interventions to Enhance Physical and Psychological Functioning Among Younger Women Who Are Ending Nonhormonal Adjuvant Treatment for Early-Stage Breast Cancer

Abstract

A B S T R A C T PurposeTo conduct a clinical trial to determine if an educational intervention and a nutritional intervention could enhance physical and psychological functioning among younger women completing treatment for early-stage breast cancer. Patients and MethodsYounger women (50 years of age or younger, N ϭ 252), within 2 months of having completed active nonhormonal adjuvant therapy, diagnosed with stage 0, I, or II breast cancer with 10 or fewer positive lymph nodes were randomly assigned to a three-arm clinical trial. Women in the control arm of the trial received standard medical care. Women in the two active arms received either an educational intervention, designed to provide information about their illness and enhance adjustment, or a nutritional intervention, designed to promote a more healthy diet. Primary end points included mental functioning, physical functioning, and depressive symptoms. Women were assessed before random assignment, 4 months later (immediately postintervention), and 13 months later (9 months postintervention). Results Participants assigned to the two active treatment arms had significantly less depressive symptomatology and better physical functioning by 13-month follow-up (differences between the two active arms were nonsignificant). These effects were primarily accounted for by changes in intrusive thoughts, concerns regarding cancer recurrence and mortality, self-concept perceptions, and self-efficacy expectations. Conclusion Tailored psychosocial interventions can be effectively designed to enhance adjustment among younger women who are completing nonhormonal adjuvant therapy.

Sexual Self Schema as a Moderator of Sexual and Psychological Outcomes for Gynecologic Cancer Survivors

“…With these data, a new finding was the negative contribution of symptomsparticularly vaginal changes and fatigue-to women's worries and stress regarding body changes. Some quality of life studies have used the KPS or patient symptom reports (Dodd, 1988;Northouse, Kershaw, Mood, & Schafenacker, 2005;Scheier et al, 2005), but the use of the symptom-atology and toxicity listing is novel. These measures are costly, as medical expertise is required of the rater (e.g., a nurse specialist), yet they provide the benefit of objective, symptom-specific scales, unlike patient self reported health which is prone to reporting biases, including co-variation with negative affect (e.g., Denollet, 1991;Geisser, Roth, Theisen, Robinson, & Riley, 2000).…”

Long-term effects on cancer survivors’ quality of life of physical training versus physical training combined with cognitive-behavioral therapy: results from a randomized trial

“…It may be that physical training has immediate effects on quality of life. Cognitivebehavioral therapy that confronts patients with personal worries and possibly increasing distress [13,28] might have long-term benefits [2,25,29]. Hence, the long-term effects of physical training combined with cognitive-behavioral therapy on quality of life may be greater compared to the effects of physical training alone.…”

Moderators of Interventions Designed to Enhance Physical and Psychological Functioning Among Younger Women With Early-Stage Breast Cancer

“…This article examines whether the main intervention effects previously reported by Scheier et al 1 were moderated or conditioned by other factors.…”

“…A recently completed clinical trial, 1 the Breast Cancer Recovery Project (BCRP), has shown that two brief psychosocial interventions, one involving a series of educational sessions and one involving a series of nutritional sessions, can reduce depressive symptomatology and enhance physical functioning among younger women diagnosed with early-stage breast cancer. This article examines whether the main intervention effects previously reported by Scheier et al 1 were moderated or conditioned by other factors.…”