Terry A. Badger

Telephone interpersonal counseling with women with breast cancer: symptom management and quality of life.

PURPOSE/OBJECTIVES To examine the effectiveness of a telephone interpersonal counseling (TIP-C) intervention compared to a usual care attentional control for symptom management (depression and fatigue) and quality of life (positive and negative affect, stress) for women with breast cancer. DESIGN Experimental with repeated measures. SETTING Academic cancer center and urban, private oncology offices. SAMPLE 48 women with breast cancer who were in their mid-50s, married, and employed at the time of the study. METHODS Women were assigned to either the six-week TIP-C or attentional usual care groups. Women were matched on stage and treatment. Data were collected at baseline, after the six interventions, and one month postintervention. Measures included the Center for Epidemiologic Studies Depression Scale, Positive and Negative Affect Schedule, Multidimensional Fatigue Inventory, and Index of Clinical Stress. MAIN RESEARCH VARIABLES Depression, positive and negative affect, fatigue, and stress. FINDINGS Women in the intervention group experienced decreases in depression, fatigue, and stress over time and increases in positive affect. CONCLUSIONS The preliminary results partially supported the effectiveness of TIP-C for symptom management and quality of life. The authors hypothesized that decreased depression, reduced negative affect, decreased stress, decreased fatigue, and increased positive affect over time would be the resulting psychosocial effects, given the theoretical underpinnings of the intervention. IMPLICATIONS FOR NURSING Nurses need to assess the quantity and quality of the social support network early in treatment; women with less social support need to be referred to counseling and support services. Because these women have limited participation in face-to-face interventions, they should be encouraged to participate in telephone or online support programs or in other programs or organizations (e.g., churches, social clubs) that would provide support.

Dyadic interdependence on affect and quality-of-life trajectories among women with breast cancer and their partners

This study explored interdependence on quality-of-life factors for women with breast cancer and their partners. Multiple theoretical perspectives predict that the emotional distress experienced by women with breast cancer would be shared by their partners. To test these predictions, 48 women with breast cancer and their partners (husbands, daughters, friends, or other relations) participated in a three-wave, 10- week, longitudinal study. Quality-of-life (QOL) indicators (depressive symptoms, positive and negative affect, and stress) were measured in both women and their partners. Baseline data revealed significant partner effects from stress and negative affect in women with breast cancer to their partners’ depression. Analysis of QOL rates and directions of change over time revealed that the QOL was on a similar trajectory. As the emotional well-being of women with breast cancer improved or deteriorated, their partners’ well-being changed also.

Depression in men with prostate cancer

PURPOSE/OBJECTIVES To summarize the current empirical knowledge base on depression in men with prostate cancer to inform psychosocial supportive care interventions for this population and chart directions for future research. DATA SOURCES Reports in English of quantitative studies that included measures of depression or mood in samples of men with prostate cancer published from 1988-2004. DATA SYNTHESIS Nurse researchers are playing a key role in establishing the scientific knowledge base upon which a better understanding of the relative importance of depression in men with prostate cancer will emerge. This review indicates that (a) predictable risk factors exist for depression among men with prostate cancer, (b) different prostate cancer treatments do not tend to be associated with differential outcomes in depression or mood, and (c) overall, men with prostate cancer report fewer depressive symptoms than women with breast cancer. CONCLUSIONS The small body of research addressing depression in men with prostate cancer is methodologically inadequate to estimate the overall prevalence of depression among men with prostate cancer and determine the clinical significance of psychoeducational interventions targeting depression or mood in this population. IMPLICATIONS FOR NURSING Nurses can use current knowledge to identify men with prostate cancer who are most at risk for depression. Evidence supporting the benefit of psychoeducational interventions for depression in other cancer populations (e.g., women with breast cancer) may be applicable to men with prostate cancer.

Psychosocial interventions to improve quality of life in prostate cancer survivors and their intimate or family partners

PurposeThe primary purpose was to test the effectiveness of two telephone-delivered psychosocial interventions for maintaining and improving quality of life (QOL) (psychological, physical, social, and spiritual well-being) among 71 prostate cancer survivors and the 70 intimate or family partners who were supporting them in their recovery.MethodsThis study used a three-wave repeated measures experimental design. Both the interpersonal counseling intervention (TIP-C) and health education attention condition (HEAC) were delivered using the telephone.ResultsImprovements in depression, negative affect, stress, fatigue, and spiritual well-being were significantly higher for survivors in the HEAC than for those in the TIP-C condition. Partners in the HEAC condition showed significantly greater improvements in depression, fatigue, social support from family members, social well-being, and spiritual well-being compared to partners in the TIP-C condition. The results revealed superior outcomes for those assigned to the HEAC intervention.ConclusionsThe psychosocial interventions in this study were effective in maintaining or improving the QOL for prostate cancer survivors and their partners. Both the survivor and their intimate partner or family member benefitted from the interventions. Future research is needed to determine the optimal timing and client characteristics for each intervention.

Interpersonal well-being and mental health among male partners of women with breast cancer

The focus of this investigation was on the mental health of men whose partners had recently been diagnosed with breast cancer. In accord with theoretical models that specify the importance of interpersonal relationships in maintaining mental health, mens relationship satisfaction and perceptions of social support were predicted to be positively associated with their mental health during this stressful time. The sample included 63 male partners of women with breast cancer who participated in a three-wave panel study that assessed various indicators of mental health and interpersonal well being at T1, T1 + 6 weeks, and T1 + 10 weeks. Results indicated substantial distress in at least 25% of the men. However this distress subsided over time. Relationship satisfaction was both concurrently and prospectively associated with better mental health. Social support was negatively associated with concurrent mental health but post hoc analyses suggested that mens social networks perhaps provide greater social support to the extent that the men are emotionally distressed.

Telephone-delivered health education and interpersonal counseling improve quality of life for Latinas with breast cancer and their supportive partners.

This study aims to test two telephone‐delivered interventions for their efficacy in improving quality of life (QOL) (psychological, physical, social, and spiritual) among Latinas with breast cancer and their family members or friends (labeled supportive partners in this study).

Putting evidence into practice®: Interventions for depression

Depression and depressive symptoms are prevalent in people with cancer, yet interventions for depression are a low priority for most oncology care providers. Barriers to diagnosis and treatment include beliefs by patients and providers that depression is an expected correlate of cancer diagnosis, the reluctance of patients to share psychological concerns, and the reticence of some professionals to assess patients with cancer for depressive symptoms in the midst of busy oncology settings. Intervening to diminish depressive symptoms in people with cancer is important because depression has been associated with poorer quality of life, recovery, and possibly survival. This article reviews and summarizes the evidence for pharmacologic and nonpharmacologic interventions for people with cancer and depression and identifies opportunities for future research and practice change.

A case study of telephone interpersonal counseling for women with breast cancer and their partners.

PURPOSE/OBJECTIVES To present a case study of one woman with breast cancer and her partner to provide a firsthand account of an innovative telephone interpersonal counseling intervention. DATA SOURCES Journal articles, book chapters, research data, and transcriptions of telephone counseling sessions. DATA SYNTHESIS Substantial evidence exists that face-to-face psychosocial interventions improve psychological adjustment and health-related quality of life for patients with cancer. Yet psychosocial interventions are not offered routinely, and many patients with cancer do not use face-to-face counseling mechanisms. The telephone may be an innovative and effective method of delivering interventions, and telephone-delivered interpersonal counseling may be an especially effective intervention for women with breast cancer and their partners. CONCLUSIONS Despite the fact that the telephone counseling occurred over a brief period of time, the woman and her partner in this case study reported substantial positive changes in their own distress (e.g., symptoms such as depression and anxiety) and the nature of their relationships with each other and their children. This is precisely the effect that would be predicted by interpersonal theories of psychological distress. These results were not atypical for other women and their partners who participated in the study. IMPLICATIONS FOR NURSING Family members play a significant role in supporting women through the breast cancer experience; thus, nurses should assess the emotional distress of both partners during the course of treatment and, if needed, provide critical education and referral to psychosocial interventions. This woman and her partner clearly benefited from the intervention, resulting in improved symptom management and quality of life. Although this intervention requires additional training in the advanced practice nursing role, some techniques of the intervention can be used by all nurses, regardless of specialty training.

Psychological and physical distress are interdependent in breast cancer survivors and their partners

Objective: Breast cancer diagnosis and treatment negatively affect quality of life in survivors and their supportive partners. The purpose of this investigation was to assess the degree of dyadic interdependence in psychological and physical symptom distress in dyads adjusting to breast cancer. Method: Participants were 49 breast cancer survivors and their partners, who were spouses, other family members, or friends of the survivor. Psychological distress (depression, anxiety, and negative affect) and physical symptom distress were measured at three points in time, each separated by eight weeks. Results: Survivors and partners exhibited significant interdependence in psychological and physical symptom distress over the four-month course of the investigation. This was evident in longitudinal partner effects in actor–partner interdependence models as well as in significant T1→T3 indirect effects mediated by partner distress. Conclusions: The course of breast cancer survivors’ psychological and physical symptom distress is significantly affected by that of their supportive partners and vice versa.

Body image perceptions in men with prostate cancer

PURPOSE/OBJECTIVES To describe changes in body image among men with prostate cancer who were either prescribed androgen-deprivation therapy (ADT) or were ADT naive and to explore the relationship of age, duration of therapy, and body mass index with body image perception. DESIGN Exploratory and descriptive. SETTING Ambulatory care clinic of a large urban Veterans Affairs medical center. SAMPLE 132 men 60 years of age or older with prostate cancer recruited from the oncology and urology outpatient departments. METHODS Participants completed a demographic survey and the Body Image Scale (BIS), an instrument developed to measure changes in body image. Descriptive and inferential statistics were used to explore body image dissatisfaction. MAIN RESEARCH VARIABLES Body image and ADT. FINDINGS A significant difference in body image dissatisfaction existed between men who had received ADT and men who were ADT naive. No relationship was identified between age and body image dissatisfaction or between duration of therapy and body image dissatisfaction. A significant positive relationship was found between body mass index and body image dissatisfaction for the sample overall. CONCLUSIONS A greater degree of body image dissatisfaction existed in the men who received ADT as compared to those who were ADT naive. IMPLICATIONS FOR NURSING Patients receiving ADT for prostate cancer may be at greater risk of body image dissatisfaction. The psychometric performance of the BIS lends support to its continued use in this population.