A Randomized Controlled Trial
Sakiko Fukui, R.N., PH.D.1,2, Akira Kugaya, M.D., PH.D.1, Hitoshi Okamura, M.D., PH.D.1, Masae Kamiya, C.S.W.1, Makiko Koike, M.A.1, Tatsuro Nakanishi, M.D.4, Shigeru Imoto, M.D., PH.D.3, Katsuko Kanagawa, R.N., PH.D.2, Yosuke Uchitomi, M.D., PH.D.1
1 Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwanoha, Kashiwa, Chiba, Japan. 2 Department of Community Health Nursing, Faculty of Medicine, University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan. 3 Division of Breast Surgery, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Chiba, Japan. 4 Department of Psychiatry, Kashiwa Hospital, Jikei Medical University, Kashiwashita, Kashiwa, Chiba, Japan.
BACKGROUND. To the authors' knowledge, there had been no evidence for the efficacy of psychosocial intervention among Japanese cancer patients. The objective of this study was to determine the effect of a psychosocial group intervention in reducing psychologic distress and enhancing coping in this population in a randomized controlled trial.
METHODS. The patient selection criteria were age younger than 65 years, lymph node metastasis positive and/or histologic or nuclear Grade 2-3, and surgery undergone within the previous 4-18 months as of the start of the study. We conducted a 6-week, structured, psychosocial group intervention. The intervention consisted of health education, coping skills training, stress management, and psychologic support. Subjects were assessed for psychologic distress and coping by administering the Profile of Mood States (POMS), Mental Adjustment to Cancer (MAC) scale, and Hospital Anxiety and Depression (HADS) scale at the baseline, at 6 weeks, and at 6 months.
RESULTS. Fifty (33%) of the 151 patients participated and were randomized, and 46 (30%) completed the study. The experimental group had significantly lower scores than the controls for total mood disturbance and significantly higher scores for vigor on the POMS, and significantly higher scores for fighting spirit on the MAC at the end of the 6-week intervention. These improvements were sustained over 6 months of follow-up.
CONCLUSIONS. The results of this study suggest that a short term psychosocial group intervention produces significant long term improvement in the quality of life of Japanese patients with primary breast carcinoma.
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