Supportive-Expressive Group Therapy and Distress in Patients With Metastatic Breast Cancer

Classen, Catherine; Butler, Lisa D.; Koopman, Cheryl; Miller, Elaine L.; Dimiceli, Sue; Giese‐Davis, Janine; Fobair, Patricia; Carlson, R. W.; Kraemer, Helena C.; Spiegel, David

doi:10.1001/archpsyc.58.5.494

Cited by 455 publications

(341 citation statements)

References 54 publications

Supporting

Mentioning

309

Contrasting

Unclassified

Order By: Relevance

“…The 21-item scale yields a total score and 5 subscale scores: New Possibilities, Relating to Others, Personal Strength, Spiritual Change, and Appreciation of Life. Items are rated on a 6-point Likert scale, ranging from "I did not experience this change as a result of my crisis" (0) to "I experienced this change to a very great degree as a result of my crisis" (5). "My priorities about what is important in life."…”

Section: 90mentioning

confidence: 99%

“…However, previous clinical trials of face-to-face support groups [5][6][7][8] for women with breast carcinoma demonstrate significant evidence of 1) an improvement in quality of life, 2) a reduction of psychologic symptoms, 3) an improvement in coping responses, and 4) a reduction in pain. Recent reports also indicate that positive effects from group interventions can be found in women from different cultures.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Electronic support groups for breast carcinoma

Lieberman

Golant

Giese‐Davis

et al. 2003

Cancer

Self Cite

231

140

View full text Add to dashboard Cite

BACKGROUNDA recent Pew Charitable Trust study found that 52,000,000 individuals used the Internet to obtain health/medical information. Clinical trials of face‐to‐face breast carcinoma support groups show evidence of 1) improvement in quality of life, 2) reduction of psychologic symptoms, 3) improvement in coping responses, and 4) a reduction in pain. To the authors' knowledge, a few studies published to date have investigated Internet‐delivered electronic support groups (ESGs) for cancer. The most sophisticated is the Comprehensive Health Enhancement Support System (CHESS) program, which provides integrated information, referral, and a newsgroup‐based social support program. However, to the authors' knowledge, no studies published to date have examined the impact of a breast carcinoma ESG in a clinical trial.METHODSSixty‐seven women completed the initial baseline questionnaires, 32 of whom accepted the authors' invitation and began the groups. With regard to geographic location, 49% lived in rural/small towns, 41% lived in medium‐sized cities, and 10% lived in large cities. Diagnostic stages of disease were: Stage I, 22%; Stage II, 56%; Stage III, 12%; and other forms, 10%. There were 4 intervention groups, of which 8 participants led by trained Wellness Community (TWC) (a national agency) leaders met for 1.5 hours once a week for 16 weeks. Student t tests for paired outcome data were computed using baseline and postgroup scores.RESULTSThe results of the current study indicated that breast carcinoma patients significantly reduced depression (Center for Epidemiologic Studies‐Depression [CES‐D] scale) and Reactions to Pain. They also demonstrated a trend toward increases on The Posttraumatic Growth Inventory (PTGI) in two subscales: New Possibilities and Spirituality. Counterintuitively, breast carcinoma patients appeared to demonstrate an increase in emotional suppression. Postinterview results indicated that approximately 67% of patients found the group to be beneficial. Those who withdrew from the groups (20%) demonstrated low scores in their ability to contain anxiety and appeared to be more likely to suppress their thoughts and feelings regarding their illness.CONCLUSIONSThe findings of the current study are encouraging, particularly because it was conducted through TWC, a national agency willing to make this type of intervention readily available at no cost. A limitation of the current study was the lack of randomization and a control group comparison. Although the authors were not able to demonstrate effectiveness without the addition of a control condition, the analysis of pregroup and postgroup outcomes suggests that a randomized trial is worthwhile. Women with a devastating disease will join and commit themselves to an online support group. In addition, because a large percentage of these women were from rural locations, this type of intervention may hold promise for those who have limited access to support groups. Cancer 2003;97:920–5. © 2003 American Cancer Society.DOI 10.1002/cncr.11145

show abstract

Section: 90mentioning

confidence: 99%

mentioning

confidence: 99%

Electronic support groups for breast carcinoma

Lieberman

Golant

Giese‐Davis

et al. 2003

Cancer

Self Cite

231

140

View full text Add to dashboard Cite

show abstract

“…1,4 -7 These trials are summarized in Table 1. Four 1,13-15 of the five trials have reported survival outcomes; and one additional trial, 16 which represents the attempt by Spiegel et al to replicate their previously reported survival benefit, has not yet produced a report of survival effects.…”

Section: The Current Evidencementioning

confidence: 99%

“…It also has been argued that women in the control arm of the study did not live as long as women with metastatic breast cancer in the community, leading to concerns that the control group in the study by Spiegel et al was not an appropriate comparison group (although the intervention and control arms were formed by randomization). 19 In evaluating this criticism, it should be pointed out that the main purpose of randomization is to avoid bias in treatment allocation, not to ensure that the control group is 16 and the other, 15 which was conducted by our group, involved training of group leaders by Spiegel to ensure that the intervention was replicated accurately. Two other groups 13,14 used shorter interventions (35 weeks, 5 mos) that included cognitive-behavioral group therapy and, in one study, 13 elements of supportive-expressive therapy as well as coping skills training.…”

Section: Effect Of Group Support On Survival In Metastatic Breast Cancermentioning

confidence: 99%

“…11 The experience of pain was related strongly to mood, with 50% of the variance in pain explained by mood. 21 In their follow-up trial, 16 women who were randomized to the group experienced fewer symptoms of the stress-response syndrome; and, when the final measurement during the last year of life was excluded, a significant reduction in mood disturbance also was observed. This adjustment was made because of concern that mood deteriorated sharply just before death and that a measurement done close to death may exert undue influence on the overall statistical analysis.…”

Section: Psychosocial Effects Of Group Interventions In Metastatic Brmentioning

confidence: 99%

See 1 more Smart Citation

Support groups in advanced breast cancer

Goodwin

2005

Cancer

View full text Add to dashboard Cite

Considerable research has been conducted into the potential benefits of support groups for patients with metastatic breast cancer. An early report by Spiegel et al. suggested that participation in these groups not only had psychologic benefits but also resulted in prolongation of survival. A review of the published literature was women with metastatic breast cancer who had participated in a randomized trial of group psychosocial support group a decade earlier. These results, which were published in The Lancet, 1 attracted worldwide attention. They proved to be a turning point in psychosocial oncology, opening the door to the possibility of a beneficial survival effect of psychologic interventions in a difficult to treat, and uniformly fatal, oncology setting: metastatic breast cancer. Because the result was unexpected and the study involved only 86 women, members of the scientific community recognized that replication was necessary. However, the results of Spiegel et al. were embraced as conclusive evidence of benefit by many women with breast cancer who were seeking to do everything they could to prolong their survival; by the breast cancer advocacy movement, which was just gaining momentum; and, at times, by members of the clinical and research communities.Survival benefits also have been reported for a brief, individual intervention in a randomized trial in gastrointestinal cancer 2 and a brief group psychosocial intervention in a randomized trial in earlystage melanoma. 3 The latter recently was updated after 10 years of follow-up. 4 The effect of the intervention on recurrence and death was weakened and was not significant in univariate analyses. In 2596

show abstract

Use of the Internet and E-mail for Health Care Information

Baker¹,

Wagner²,

Singer³

et al. 2003

JAMA

1,037

683

View full text Add to dashboard Cite

ContextThe Internet has attracted considerable attention as a means to improve health and health care delivery, but it is not clear how prevalent Internet use for health care really is or what impact it has on health care utilization. Available estimates of use and impact vary widely. Without accurate estimates of use and effects, it is difficult to focus policy discussions or design appropriate policy activities.Objectives To measure the extent of Internet use for health care among a representative sample of the US population, to examine the prevalence of e-mail use for health care, and to examine the effects that Internet and e-mail use has on users' knowledge about health care matters and their use of the health care system. Design, Setting, and ParticipantsSurvey conducted in December 2001 and January 2002 among a sample drawn from a research panel of more than 60000 US households developed and maintained by Knowledge Networks. Responses were analyzed from 4764 individuals aged 21 years or older who were self-reported Internet users.Main Outcome Measures Self-reported rates in the past year of Internet and e-mail use to obtain information related to health, contact health care professionals, and obtain prescriptions; perceived effects of Internet and e-mail use on health care use. ResultsApproximately 40% of respondents with Internet access reported using the Internet to look for advice or information about health or health care in 2001. Six percent reported using e-mail to contact a physician or other health care professional. About one third of those using the Internet for health reported that using the Internet affected a decision about health or their health care, but very few reported impacts on measurable health care utilization; 94% said that Internet use had no effect on the number of physician visits they had and 93% said it had no effect on the number of telephone contacts. Five percent or less reported use of the Internet to obtain prescriptions or purchase pharmaceutical products.Conclusions Although many people use the Internet for health information, use is not as common as is sometimes reported. Effects on actual health care utilization are also less substantial than some have claimed. Discussions of the role of the Internet in health care and the development of policies that might influence this role should not presume that use of the Internet for health information is universal or that the Internet strongly influences health care utilization.

show abstract

Supportive-Expressive Group Therapy and Distress in Patients With Metastatic Breast Cancer

Abstract: Supportive-expressive therapy, with its emphasis on providing support and helping patients face and deal with their disease-related stress, can help reduce distress in patients with metastatic breast cancer.

Cited by 455 publications

References 54 publications

Electronic support groups for breast carcinoma

Electronic support groups for breast carcinoma

Support groups in advanced breast cancer

Use of the Internet and E-mail for Health Care Information

Contact Info

Product

Resources

About