Reducing symptom limitations: A cognitive behavioral intervention randomized trial

Abstract

SUMMARYUntil now, little research has been conducted examining the reactive dimension, or the degree to which a symptom limits an individual's life, in a multiplicity of symptoms. This research examines how problem-solving therapy organizes an intervention to decrease symptom limitations. The purpose was threefold: to determine if a cognitive behavioral intervention decreases the impact of symptom limitations among individuals newly diagnosed with cancer, who are receiving chemotherapy; to determine, after adjusting for covariates, how symptom limitations change over time; and to describe which symptoms are most limiting. This randomized control trial was conducted in two comprehensive and four community cancer centers. Two hundred thirty-seven individuals, aged 31-87, newly diagnosed with solid tumor cancers, participated. The experimental group (118 individuals) received a 10-contact, 18-week cognitive behavioral intervention focused on cancerand chemotherapy-related symptoms. The control group (119 individuals) received conventional care. Interviews occurred at baseline, 10, 20, and 32 weeks. Data analysis used a two-level hierarchical linear model. Participants receiving the cognitive behavioral intervention had lower scores of symptom limitation than did participants in the control group. At the onset of the study, younger patients reported more symptom limitations than their older counterparts; however, this was reversed by the end of the study. The cognitive behavioral intervention was key to decreasing symptom limitations. Findings also suggest that nursing interventions may be particularly helpful to younger individuals in managing cancer-related symptom limitations.

Development of a Psychoeducational Intervention for Men with Prostate Cancer

“…Self-care strategies have been found to enhance psychological wellbeing among people with cancer (Devine & Westlake, 1995) and reduce anticipatory anxiety about medical procedures or treatments, such as colonoscopy (Luck, Pearson, Maddern, & Hewett, 1999) or radiotherapy/chemotherapy (Thomas et al, 2000). A number of intervention studies have demonstrated other benefits of providing patients with such skills including increased treatment compliance, a sense of control, and realistic expectations (Carver, 2005;Doorenbos, Given, Given, & Verbitsky, 2006;Doorenbos et al, 2005).…”

Palliative care needs of cancer outpatients receiving chemotherapy: an audit of a clinical screening project

“…Several intervention trials have suggested that the routine use and feedback to the treating physicians of quality-of-life measurements or symptom assessment scales could contribute to improving physician recognition of patient quality-of-life aspects with some beneficial effects on patient psychological well-being [13][14][15][16][17]. On the other hand, some clinical trials including more intensive interventions, such as cognitive behavior intervention with systematic identification of patient needs, have demonstrated positive outcomes in patient physical well-being, not only psychological issues [18][19][20][21][22]. In addition, multidisciplinary intervention by specialized palliative care teams in outpatient settings could contribute to enhancing patient quality-of-life [23][24][25][26].…”

Approach to Fever Assessment in Ambulatory Cancer Patients Receiving Chemotherapy: A Clinical Practice Guideline

“…Improvement in symptoms was seen with interventions such as cognitive behavioural therapy provided by nurses 31 ; pre-chemotherapy education class supplemented with take-home reading materials and instructions on how and when to report symptoms 32 ; a symptom management toolkit describing self-assessment activities 26 ; and education, a fever management algorithm, and a thermometer 33 .…”