Effect of a cognitive behavioral intervention on reducing symptom severity during chemotherapy. Individual Psychosocial Support for Breast Cancer Patients: A Randomized Study of Nurse Versus Psychologist Interventions and Standard Care Effects of two types of social support and education on adaptation to early-stage breast cancer. Development and pilot testing of a psychoeducational intervention for oral cancer patients. Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial. The effects of concrete objective information and relaxation on maintaining usual activity during radiation therapy. Facilitation of self-transcendence in a breast cancer support group: II. A problem‐solving approach to stress reduction among younger women with breast carcinoma Lessons Learned: Outcomes and Methodology of a Coping Skills Intervention Trial Comparing Individual and Group Formats for Patients with Cancer Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. A Randomized Controlled Trial of Psychosocial Interventions Using the Psychophysiological Framework for Chinese Breast Cancer Patients Intervention to improve psychological functioning for newly diagnosed patients with cancer. Effect of individual psychological intervention in Chinese women with gynecologic malignancy: a randomized controlled trial. Short-term effects of telephone therapy for breast cancer patients. Telephone social support and education for adaptation to prostate cancer: a pilot study. Investigating the active ingredients of cognitive behaviour therapy and counselling for patients with chronic fatigue in primary care: developing a new process measure to assess treatment fidelity and predict outcome. Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. An Intervention to Increase Quality of Life and Self-Care Self-Efficacy and Decrease Symptoms in Breast Cancer Patients Psychoeducational intervention for patients with cutaneous malignant melanoma: a replication study. Effects of advanced nursing care on quality of life and cost outcomes of women diagnosed with breast cancer. Counseling women with breast cancer using principles developed by Albert Bandura. Effects of a brief intervention program for patients with cancer and their partners on feelings of inequity, relationship quality and psychological distress. Improving health outcomes among youth with poorly controlled type I diabetes: the role of treatment fidelity in a randomized clinical trial of multisystemic therapy. Meeting the information needs of women with breast cancer: Piloting a nurse-led intervention.
PURPOSE To describe a r and omized trial of a cognitive behavioral intervention on reducing symptom severity among patients diagnosed with solid tumors and undergoing a first course of chemotherapy and to determine whether the intervention had an additive or interactive effect on symptom severity in the presence of supportive care medications . PATIENTS AND METHODS Patients ( N = 237 ) were accrued from comprehensive and community cancer centers , interviewed , and r and omly assigned to either the experimental intervention ( n = 118 ) or conventional care ( n = 119 ) . A symptom severity index , based on summed severity scores across 15 symptoms , was the primary outcome . Each patient 's site of cancer , stage at diagnosis , chemotherapy protocol s , and use of supportive medications were learned from medical records . RESULTS Groups were equivalent at baseline , and attrition by characteristics by group was not different . The proportion of patients not receiving chemotherapy at 10 and 20 weeks did not differ by group . At the 10- and 20-week observations , there was a significant interaction between the experimental group and baseline symptom severity . Patients in the experimental group who entered the trial with higher symptom severity reported significantly lower severity at 10 and 20 weeks . Controlling for chemotherapy treatment status at follow-up and supportive care medications did not alter the effect of the experimental intervention . CONCLUSION Compared with conventional care alone , the experimental intervention was effective among patients who entered the trial with higher levels of symptom severity . Age , sex , site or stage of cancer , and supportive medications did not modify the effect of this cognitive behavioral intervention on symptom severity In a prospect i ve , r and omized study , an individual psychosocial support intervention performed by specially trained oncology nurses , or psychologists , were compared with st and ard care .  Consecutive primary breast cancer patients about to start adjuvant therapy ( n = 179 ) were included . Data were supplied by the question naires European Organisation for Research and Treatment of Cancer Quality of Life Study Group Core Quality of life question naire with 30 questions ( EORTC QLQ-C30 ) and Breast Cancer Module with 23 questions ( BR23 ) , the Hospital Anxiety and Depression Scale , Spielberger 's State-Trait Anxiety Inventory , and the Impact of Event Scale before r and omization and 1 , 3 , and 6 months later . Patient files provided data on utilization of psychosocial support offered in routine care . Global quality of life/health status , nausea and vomiting , and systemic therapy side effects were the subscales showing significant Group by Time interactions , favoring the interventions . Intervention groups improved statistically significantly more than the st and ard care group regarding insomnia , dyspnea , and financial difficulties . Nurse patients experienced less intrusion compared with the st and ard care group . All groups showed statistically and clinical ly significant improvements with time on several subscales . The intervention groups , however , improved to a greater extent . Fewer patients in the intervention groups used psychosocial hospital support compared with the st and ard care group . In conclusion , psychosocial support by specially trained nurses using techniques derived from cognitive behavioral therapy is beneficial for breast cancer patients and may be a realistic alternative in routine cancer care A Roy adaptation model-based support and education intervention for women with early-stage breast cancer was tested in a three-group , three-phase r and omized clinical trial of a sample of 125 women . The experimental group received 13 months of combined individual telephone and in-person group support and education , Control Group 1 received 13 months of telephone-only individual support and education , and Control Group 2 received one-time mailed educational information . The experimental group and Control Group 1 reported less mood disturbance at the end of all three phases , less loneliness at the end of Phases II and III , and a higher- quality relationship with a significant other at the end of Phase II than did Control Group 2 . No group differences were found for cancer-related worry or well-being . The findings suggest that individual telephone support may provide an effective alternative to in-person support groups . Further study of telephone interventions is recommended using ethnically and economically heterogeneous sample OBJECTIVE Oral cancer elicits considerable distress in both the pre and post-treatment periods . This paper details the development , validation and pilot-testing of a psychoeducational intervention for oral cancer patients . METHOD An educational booklet covering information about oral cancer and its treatment and effective coping strategies was developed by a multi-disciplinary team . It was evaluated by patient focus groups and content/educational experts , delivered to subjects in pre and post-operative presentations by a health educator , and pilot-tested in a r and omized controlled trial versus st and ard care . RESULTS Pilot data from 19 subjects ( 10 psychoeducation , nine st and ard care )  indicates that the intervention is feasible and highly acceptable . At follow-up the intervention group showed a gain in knowledge , less body image disturbance , lower anxiety and a trend toward higher wellbeing . CONCLUSION This program , which is currently being evaluated in a larger RCT with extended follow-up , should prove useful in reducing the psychosocial burden of oral cancer and its treatment PURPOSE This r and omized clinical trial tests the hypothesis that a psychological intervention can reduce emotional distress , improve health behaviors and dose-intensity , and enhance immune responses . PATIENTS AND METHODS We studied 227 women who were surgically treated for regional breast cancer . Before adjuvant therapy , women completed interviews and question naires assessing emotional distress , social adjustment , and health behaviors . A 60-mL blood sample was drawn for immune assays . Patients were r and omly assigned to either the intervention group or assessment only group . The intervention was conducted in small patient groups , with one session per week for 4 months . The sessions included strategies to reduce stress , improve mood , alter health behaviors , and maintain adherence to cancer treatment and care . Re assessment occurred after completion of the intervention . RESULTS As predicted , patients receiving the intervention showed significant lowering of anxiety , improvements in perceived social support , improved dietary habits , and reduction in smoking ( all P < .05 ) . Analyses of adjuvant chemotherapy dose-intensity revealed significantly more variability ( ie , more dispersion in the dose-intensity values ) for the assessment arm ( P < .05 ) . Immune responses for the intervention patients paralleled their psychological and behavioral improvements . T-cell proliferation in response to phytohemagglutinin and concanavalin A remained stable or increased for the Intervention patients , whereas both responses declined for Assessment patients ; this effect was replicated across three concentrations for each assay ( all P < .01 ) . CONCLUSION These data show a convergence of significant psychological , health behavior , and biologic effects after a psychological intervention for cancer patients PURPOSE / OBJECTIVES To examine the effects of concrete objective information ( COI ) and relaxation instruction ( RI ) on patients undergoing radiation therapy  , as well as the contribution of symptom uncertainty and body awareness to the intervention effects . DESIGN Three-group r and omized trial . Assignment was stratified by cancer site . Data collectors were blinded to group assignments . SETTING University medical center radiation therapy department serving both urban and rural communities in the southeastern United States . SAMPLE 76 adults having radiation with curative intent for gynecologic , head and neck , or lung cancer . Most were Caucasian and had in situ to stage II disease . Mean age was 55 years . METHODS COI and RI were delivered by tape recordings . Outcome measures were indicators of usual activities and emotions at treatment week 3 and two and four weeks post-treatment . MAIN RESEARCH VARIABLES Intervention group ; social , household , and recreational activities ; anxiety , depression , and anger ; body awareness ; and symptom uncertainty . FINDINGS Participants receiving either intervention reported more social activity during treatment . Those given RI who were high in body awareness reported more household activity during treatment . No effects were found regarding emotion . Symptom uncertainty partially explained COI effects . CONCLUSIONS The findings provide additional support for the effectiveness of COI in helping patients to maintain more of their usual activities during radiation therapy . Instruction in progressive muscle relaxation also may help in maintaining activities . IMPLICATION S FOR NURSING COI helps patients to cope with treatment by reducing their uncertainty about symptoms . RI effects may vary by activity type and awareness of usual body sensations PURPOSE / OBJECTIVES To pilot a second support group intervention study promoting self-transcendence perspectives and activities and to document changes over time in well-being in support group participants compared with non participants . DESIGN Quasiexperimental , partial r and omization , preference trial design . SETTING An urban breast cancer re source center established by survivors . SAMPLE 41 women with newly diagnosed breast cancer were recruited , and 39 completed the study . 22 women participated in three intervention support groups ; 17 were in a comparison group . METHODS The intervention was an eight-week , closed support group based on self-transcendence theory . Data were collected three times during 14 months . MAIN RESEARCH VARIABLES Support group intervention , self-transcendence , and emotional and physical well-being . FINDINGS The intervention group had lower scores than the comparison group on self-transcendence and well-being variables at baseline ( time [ T ] 1 ) . Scores were higher for both groups postintervention ( T2 ) , with no differences between groups . One year postintervention ( T3 ) , intervention group scores again were lower than comparison group scores . Intervention group T3 scores were unchanged from T2 . CONCLUSIONS Most potential participants were unwilling to risk being r and omized into a nonpreferred group . Activities based on self-transcendence theory were associated with exp and ed perspectives and activities and an improved sense of well-being in support group participants at the end of the intervention , but not one year later . Findings from the pilot studies informed a study currently in progress . IMPLICATION S FOR NURSING Nurses should maintain awareness of local re sources for support and make that information available to women when they are newly diagnosed with breast cancer , during their treatment , and later Previous research indicates that younger women ( i.e. , ≤ 50 ) with breast carcinoma experience greater emotional distress than older women ( i.e. , > 50 ) and that coping style is significantly related to the psychosocial adjustment of women with this disease . The purpose of this study was to evaluate through a r and omized controlled trial the effectiveness of a problem‐solving training intervention design ed to empower women with breast carcinoma to cope with a range of difficulties when diagnosed in mid‐life Objective : Nucare , a short-term psychoeducational coping skills training intervention was evaluated in a r and omized controlled clinical trial ( RCT ) of 225 newly diagnosed breast and colon cancer patients . Method : Measures of psychosocial distress , well being and optimism were evaluated every four months during a one-year period . Patients were r and omized to one of four arms : Nucare presented in an individual basis ; Nucare presented in a group format ; a non-directive supportive group ; and a no-intervention control . The interventions were provided in five sessions of ninety minutes each . Results : Patients with breast cancer who received Nucare  presented in an individual format showed more significant improvements in well-being over time compared to those in the control and group arms . Conclusions : We were unable to develop functioning groups within the RCT . Partial explanations for the latter finding include the structural limitations of the RCT : the groups were small , difficult to schedule and patients indicated that they would have preferred to choose whether or not to participate in a group . The positive changes in women with breast cancer who received Nucare persisted at 12 months PURPOSE Professionally administered psychosocial interventions have been shown to improve the quality of life of cancer patients undergoing chemotherapy . The present study sought to improve access to psychosocial interventions during chemotherapy treatment by evaluating the efficacy and costs of a patient self-administered form of stress management training that requires limited professional time or experience to deliver . PATIENTS AND METHODS Four hundred eleven patients about to start chemotherapy were r and omly assigned to receive usual psychosocial care only , a professionally administered form of stress management training , or a patient self-administered form of stress management training .  Quality -of-life assessment s were conducted before r and omization and before the second , third , and fourth treatment cycles . Intervention costs were estimated from both payer and societal perspectives . RESULTS Compared with patients who received usual care only , patients receiving the self-administered intervention reported significantly ( P < or = .05 ) better physical functioning , greater vitality , fewer role limitations because of emotional problems , and better mental health . In contrast , patients who received the professionally administered intervention fared no better in terms of quality of life than patients receiving usual care only . Costs of the self-administered intervention were estimated to be 66 % ( from a payer perspective ) to 68 % ( from a societal perspective ) less than the average costs of professionally administered psychosocial interventions for patients starting chemotherapy . CONCLUSION Evidence regarding the efficacy and favorable costs of self-administered stress management training suggests that this intervention has the potential to greatly improve patient access to psychosocial intervention during chemotherapy treatment Abstract This study aim ed to investigate the psychophysiological outcomes of different psychosocial interventions for breast cancer patients . Participants were r and omly assigned into 3 intervention groups , namely , Body-Mind-Spirit ( BMS ) , Supportive-Expressive ( SE ) , and Social Support Self-Help ( SS ) groups ; a no-intervention group was used as control .  Salivary cortisol was used as the physiological stress marker . Distress level , mental adjustment , emotional control , and social support were measured . Data were collected at baseline , 4 month , and 8 month . Preliminary results indicated that BMS intervention produced the greatest and the most sustained effects . It enhanced positive social support , reduced psychological distress , emotional control , and negative mental adjustment . Total salivary cortisol was lowered after 8 months . Most participants in SE groups indicated the treatment helpful , but changes in psychophysiological outcomes were not statistically significant . Participants in SS groups seemed less likely to benefit from the intervention . The no intervention control group indicated a reduction in social support . These outcomes suggest that active professional intervention is more likely to yield therapeutic effects . In particular , psychosocial intervention attending to the spiritual dimension contributes to positive outcomes PURPOSE / OBJECTIVES To test the effects of a computer-based nursing intervention design ed to provide patients and family caregivers with concrete , objective information on symptom management ; provide education about disease and treatment ; coordinate medical re sources ; and provide emotional support and counseling . DESIGN Two-site , r and omized clinical trial . SETTING S A large , urban , midwestern , tertiary-cancer center and a community-based cancer center in a medium-sized midwestern city . SAMPLE 109 patients newly diagnosed with breast , colon , or lung cancer who were receiving chemotherapy ; 54 received st and ard care , and 55 participated in the intervention group .  METHODS Outcome data were collected via structured telephone interviews at three time points : baseline , midway through the intervention , and one month postintervention . The intervention consisting of nine visits , five in person and four by telephone , was conducted over 18 weeks by advanced practice oncology nurses . MAIN RESEARCH VARIABLES Psychosocial functioning , anxiety , and depression . FINDINGS Patients who received the intervention had significantly less depression between baseline and the midway point , as well as less anxiety and greater improvement in the role-emotional and mental health subscales of the Medical Outcomes Study 36 Short Form . CONCLUSIONS Cancer-care nursing interventions can decrease psychosocial morbidity and improve quality of life for newly diagnosed patients with cancer undergoing treatment . Additional research is needed to underst and who benefited most from the intervention . IMPLICATION S FOR NURSING This nurse-directed intervention result ed in improved mental health for patients ; however , physical subscales were not changed . Further work is needed to determine why depression and mental health were affected yet physical health and symptoms did not differ between groups . Results support the important role of nurses in addressing mental health issues in patients and families experiencing cancer PURPOSE To evaluate the effectiveness of psychological intervention in the care of cancer patients and to determine whether routine use of individual psychological therapies is indicated . PATIENTS AND METHODS Patients with newly diagnosed gynecologic malignancies from August 1999 to November 2000 were recruited and r and omly assigned to either a control group receiving routine medical care or to an intervention group receiving individual psychotherapy . A set of fixed-choice , self-report question naires assessing the patients ' psychological status , quality of life , and their perceptions related to the medical consultations was completed at recruitment and then every 3 months for 18 months . Data analysis was performed according to the intention-to-treat principle by fitting the data into a linear mixed-effects model . Multivariable analyses were performed to examine the effects of confounding factors . RESULTS One hundred fifty-five patients participated in the trial . There were no statistically significant differences between the two groups at baseline . There was a trend toward better quality of life and functional status and also improvement of the symptoms over time for both groups . No differences were found between the groups in the scores measured by any of the instruments at baseline and at any time points after the cancer diagnosis . Psychological intervention had no significant effects on the psychosocial parameters . CONCLUSION Routine use of psychological therapies as given in our format has no significant effect on the patients ' quality of life and psychological status The authors report the short-term effects of a clinical trial testing 2 telephone therapies for breast cancer patients . Women ( N = 222 ) with breast cancer were recruited and r and omly assigned to cancer education , emotional expression , or st and ard care . Oncology nurses conducted 6 individual 30-min-therapy phone sessions . Women in the cancer education condition reported greater perceived control than women in the st and ard care condition . No treatment effects were obtained for mood or quality of life . These are the 1st data from a large-scale study testing telephone therapy , and they suggest that such therapies may be ineffective . Explanations for the results include therapy type and delivery , participant characteristics , short- versus long-term results , therapy conent , and whether therapy is necessary for breast cancer patients PURPOSE / OBJECTIVES To evaluate the feasibility of an intervention of telephone social support and education to increase the physical , emotional , functional , and interpersonal adaptation of men to prostate cancer . DESIGN Prospect i ve , r and om assignment to experimental or control treatments . SETTING Urban New Jersey . SAMPLE 17 men diagnosed with prostate cancer within four weeks of study entry . Mean age was 66 years ( range = 51 - 78 ) ; 59 % were Caucasian , 35 % were African American , and 6 % were American Indian . METHODS Subjects in the experimental group received telephone social support over a 12-month period in addition to education via mailed re source kits . The control group received education through mailed re source kits only . The Functional Assessment of Cancer Therapy Scale-General Physical , Emotional , Functional , and Social/Family Well-Being subscales ; Symptom Experience Scale-Prostate ; and the Relationship Change Scale were administered initially and at the end of each of the three phases ; the International Index of Erectile Function Scale was administered at the end of each of the three phases . Qualitative information was gathered throughout and at the conclusion of the study . MAIN RESEARCH VARIABLES Physiologic , emotional , functional , and social adaptation to prostate cancer . FINDINGS Results were somewhat more favorable for the experimental group on all outcome measures ; however , differences were not statistically significant . Structured interviews with 14 of 17 subjects revealed that  telephone social support and education  were effective in increasing adaptation to prostate cancer . CONCLUSIONS Despite the lack of a significant difference between the experimental and treatment groups in this small sample of men , analysis of trends and interview feedback indicated that telephone social support , in addition to education through a mailed re source kit , has the potential to be beneficial by increasing access to supportive services . IMPLICATION S FOR NURSING Telephone social support when supplementing patient education may assist men in adapting during the year following a prostate cancer diagnosis OBJECTIVES To develop a brief measure of the therapy process and use it to examine which therapeutic ingredients were associated with outcome in a sample of patients from a r and omized controlled trial ( RCT ) of cognitive behaviour therapy ( CBT ) versus counselling for patients with chronic fatigue in primary care . It was hypothesized that the two therapies would be clearly distinguishable and that in terms of process variables , the therapeutic alliance would be important in predicting outcome . DESIGN The data for this study were collected alongside a RCT in primary care and included audiotaped therapy sessions . These tapes were assessed by two independent raters using a newly devised measure in order to evaluate therapy process and its relationship with outcome . METHODS Tapes from 71 patients participating in the RCT were assessed to form the basis of the process analysis . Outcome was self-reported fatigue symptoms at 6 months follow-up . Data reduction was achieved via a principal component analysis ( PCA ) . Factors were entered into a multiple regression analysis to produce a final model of predictors of outcome . RESULTS The process measure showed that although the treatments could be distinguished , there was some overlap between them . The key predictor of a good fatigue outcome was emotional processing , including the expression , acknowledgement and acceptance of emotional distress . CONCLUSION A new process measure was developed successfully which now warrants further testing . It was able to assess treatment adherence and unpack , and distinguish the common factor which predicted outcome across therapy modalities . The findings lend preliminary support to the view that the specific techniques associated with particular ' br and names ' of therapy are not necessarily the ' active ingredients ' that help patient 's change within the primary care setting . Emotional processing predicted outcome for patients with chronic fatigue and therefore future research might explore this in more depth , in order to underst and better how it can be facilitated OBJECTIVES An increasingly important concern for clinicians who care for patients at the end of life is their spiritual well-being and sense of meaning and purpose in life . In response to the need for short-term interventions to address spiritual well-being , we developed Meaning Centered Group Psychotherapy ( MCGP ) to help patients with advanced cancer sustain or enhance a sense of meaning , peace and purpose in their lives , even as they approach the end of life . METHODS Patients with advanced ( stage III or IV ) solid tumor cancers ( N=90 ) were r and omly assigned to either MCGP or a supportive group psychotherapy ( SGP ) . Patients were assessed before and after completing the 8-week intervention , and again 2 months after completion . Outcome assessment included measures of spiritual well-being , meaning , hopelessness , desire for death , optimism/pessimism , anxiety , depression and overall quality of life . RESULTS MCGP result ed in significantly greater improvements in spiritual well-being and a sense of meaning . Treatment gains were even more substantial ( based on effect size estimates ) at the second follow-up assessment . Improvements in anxiety and desire for death were also significant ( and increased over time ) . There was no significant improvement on any of these variables for patients participating in SGP . CONCLUSIONS MCGP appears to be a potentially beneficial intervention for patients ' emotional and spiritual suffering at the end of life . Further research , with larger sample s , is clearly needed to better underst and the potential benefits of this novel intervention This study tested effects of a nurse-administered self-efficacy intervention given on five monthly occasions and design ed to enhance  patients ’ self-care self-efficacy . The hypotheses were that at four months and eight months after beginning chemotherapy the efficacy-enhancing experimental group would have significantly higher scores on quality of life and self-care self-efficacy than the control group and significantly less symptom distress .  Fifty-six women receiving chemotherapy for breast cancer were r and omized to the experimental and control groups . Outcome variables were quality of life , measured by the Functional Assessment of Cancer Treatment-Breast ( FACT-B ) , symptom distress , measured by the Symptom Distress Scale ( SDS ) , and factors of self-care self-efficacy  , measured by  Strategies Used by Patients to Promote Health ( SUPPH ) . The interaction effects for the FACT-B ranged from small for functional concerns ( eta square = .03 ) to large for social concerns ( eta square = .110 ) ; effects for the SDS were large ( eta square = .140 ) , and for factors on the SUPPH effect sizes ranged from small ( eta square = .01 ) for Enjoying Life and Stress Reduction to medium ( eta square = .089 ) for Coping , and large ( eta square = .141 ) for Making Decisions . Interventions to promote self-efficacy may increase quality of life and decrease symptom distress for women diagnosed with breast cancer PURPOSE In 1993 , a r and omized intervention study among patients with malignant melanoma showed a significant decrease in psychological distress and increased coping capacity 6 months after the intervention and enhanced survival 6 years later . We applied a similar intervention with a few modifications in a r and omized controlled trial among Danish patients with malignant melanoma and evaluated results on immediate and long-term effects on psychological distress and coping capacity . PATIENTS AND METHODS A total of 262 patients with primary cutaneous malignant melanoma were r and omly assigned to the control or intervention group . Patients in the intervention group were offered six weekly sessions of 2 hours of psychoeducation , consisting of health education , enhancement of problem-solving skills , stress management , and psychological support . The participants were assessed at baseline before r and om assignment and 6 and 12 months after surgery . The analyses of the main effects of the intervention were based on analyses of covariance . RESULTS The patients in the intervention group showed significantly less fatigue , greater vigor , and lower total mood disturbance compared with the controls , and they used significantly more active-behavioral and active-cognitive coping than the patients in the control group . The improvements were only significant at first follow-up . CONCLUSION The findings of this study support the results of an earlier intervention study among patients with malignant melanoma and indicate that a psychoeducational group intervention for such patients can decrease psychological distress and enhance effective coping . However , this effect is short term and the clinical relevance is not obvious PURPOSE / OBJECTIVES To evaluate quality of life ( QOL ) and cost outcomes of advanced practice nurses ' ( APNs ' ) interventions with women diagnosed with breast cancer . DESIGN R and omized clinical trial . SETTING Integrated healthcare system in a midwestern suburban community . SAMPLE 210 women with newly diagnosed breast cancer with an age range of 30 - 85 years . METHODS The control group ( n = 104 ) received st and ard medical care . The intervention group ( n = 106 ) received st and ard care plus APN interventions based on Brooten 's cost- quality model and the Oncology Nursing Society 's st and ards of advanced practice in oncology nursing QOL was measured using the Functional Assessment of Cancer Therapy , Mishel Uncertainty in Illness Scale and Profile of Mood States at seven intervals over two years . Information about costs ( charges and reimbursement ) was collected through billing systems . MAIN RESEARCH VARIABLES Uncertainty , mood states , well-being , charges , and reimbursement . FINDINGS Uncertainty decreased significantly more from baseline in the intervention versus control group at one , three , and six months after diagnosis ( p = 0.001 , 0.026 , and 0.011 , respectively ) , with the strongest effect on subscales of complexity , inconsistency , and unpredictability . Unmarried women and women with no family history of breast cancer benefited from nurse interventions in mood states and well-being . No significant cost differences were found . CONCLUSIONS APN interventions improved some QOL indicators but did not raise or lower costs . IMPLICATION S FOR NURSING PRACTICE The first six months after breast cancer diagnosis is a critical time during which APN interventions can improve QOL outcomes . More research is necessary to define cost-effective interventions PROBLEM Although research ers suggest treatments that provide patients with an active coping strategy may increase patients ' sense of self-efficacy , previous studies have not measured patients ' self-efficacy . METHODS Eighteen women receiving chemotherapy for breast cancer were r and omized to  efficacy-enhancing experimental  ( n = 10 ) and usual-care control  ( n = 8) groups . The experimental group received five interventions delivered monthly . Variables-- quality of life , symptom distress , and self-care self-efficacy -- were measured at baseline and at 4 and 8 months later . FINDINGS At 4 and 8 months the interaction effects for the Functional Assessment of Cancer Treatment-Breast , used to measure quality of life , ranged from small for functional concerns to large for social concerns . Interaction effects for symptom distress , measured by the Symptom Distress Scale , were large . Interaction effects for self-care self-efficacy ranged from small for Enjoying Life and Stress Reduction , medium for Stress Reduction , and large for Making Decisions . CONCLUSIONS Interventions to promote self-efficacy may increase quality of life and decrease distress for women diagnosed with breast cancer When one member of a couple develops a serious illness , the lives of both partners are likely to be affected . Interventions directed at both partners are generally lacking , however . In the present study , a brief counseling program directed at couples confronted with cancer was evaluated . The intervention focused mainly on the exchange of social support and help between both partners and was aim ed at restoring perceptions of equity . Couples were r and omly assigned to an experimental group or a waiting-list group . After the intervention , both patients and their partners reported lower levels of perceptions of underinvestment and overbenefit , and higher levels of relationship quality . Moreover , among patients psychological distress decreased after the intervention . These effects were generally maintained until follow-up three months later . Associations between perceptions of equity and relationship quality and psychological distress were also examined The purpose of the study was to assess whether therapist treatment fidelity was a predictor of treatment outcome in a r and omized clinical trial of multisystemic therapy with 10- to 16-year-old youths with chronically poorly controlled Type I diabetes ( N = 40 ) . Treatment fidelity was assessed by objective ratings of therapy sessions and question naires completed by caregivers and by therapists . Relationships between fidelity measures were assessed . Structural equation modeling ( SEM ) was used to test whether high fidelity would lead to improved regimen adherence and to improved metabolic control outcomes via regimen adherence . Objective ratings of treatment fidelity were significantly related to therapist-reported but not to caregiver-reported treatment fidelity . SEM results supported a completely mediated pathway between treatment fidelity and metabolic control , with regimen adherence mediating the relationship . Results suggest that conducting complex behavioral interventions with a high degree of fidelity can improve treatment outcomes among youths with chronic illnesses This study evaluated a telephone intervention , administered by specialist breast care nurses , that aim ed to meet the information needs of women with breast cancer . The intervention was developed from previous work that examined priority information needs . Participants were allocated to a telephone intervention ( n = 67 ) or control group ( n = 68 ) . Data were collected by means of semi-structured interviews with participants at two time points ( 3 months and 8 - 12 months post-diagnosis ) and focused on patient satisfaction with sources of information , information needs and psychological morbidity . Interviews were also conducted with breast care nurses to ascertain their views on administering the intervention . The intervention group reported fewer physical problems at Time 2 and were more likely to have had their information needs met than women in the control group . The control group were more likely to utilise media sources of information at Time 2 whereas women in the intervention group reported breast care nurses as their most prominent source of information . There were no significant differences in psychological morbidity between the two study groups . The findings indicate that the intervention is a feasible and acceptable approach to meeting the information needs of women with breast cancer . Further research is required to evaluate the intervention in a r and omised controlled trial
Intervention fidelity refers to strategies that practitioners and research ers use to monitor , enhance , or evaluate the accuracy and consistency of the delivery of an intervention to ensure that it is implemented according to how it was planned .
The purpose of the authors in this article was to evaluate intervention fidelity in the psychosocial oncology intervention effectiveness research .