Effect of a Cognitive Behavioral Intervention on Reducing Symptom Severity During Chemotherapy (original) (raw)
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A Cognitive Behavioral Intervention for Symptom Management in Patients With Advanced Cancer
Oncology Nursing Forum, 2005
Purpose/Objectives: To evaluate the effectiveness of a cognitive behavioral intervention in decreasing symptom severity in patients with advanced cancer undergoing chemotherapy. Design: Prospective, randomized clinical trial based on cognitive behavioral theory. Setting: Six urban cancer centers in the midwestern United States. Sample: 124 patients 21 years of age or older were recruited and randomized to receive conventional care or conventional care and an intervention. Participants were newly diagnosed with stage III, stage IV, or recurrent cancer (solid tumor or non-Hodgkin lymphoma), undergoing chemotherapy, cognitively intact, and able to read and speak English. Methods: Data were gathered via telephone interviews at baseline and 10 and 20 weeks after randomization. Nurses with experience in oncology delivered a five-contact, eight-week intervention aimed at teaching patients problem-solving techniques to affect symptom severity.
Journal of Pain and Symptom Management, 2006
Patients (n = 231) diagnosed with solid tumors and undergoing chemotherapy were randomly assigned to the experimental arm (n = 114) or to conventional care (n = 117). A symptom severity index based on summed severity scores across 15 symptoms was the primary outcome. Building on previously published work, an analysis was undertaken to determine the effects of patient characteristics and treatment complications on reductions in symptom severity achieved by a trial of a cognitive-behavioral intervention (CBI). The impact of the intervention on symptom severity differed by the occurrence of neutropenic events, chemotherapy dose delays or dose reductions, and number of comorbid conditions. Patients with more comorbid conditions, as well as those who did not experience neutropenia or dose delay/reduction, who received the intervention reported lower severity at 20 weeks compared to those who received conventional care. This research begins to specify the clinical conditions under which CBIs are effective in lowering symptom severity.
Testing the differential effects of symptom management interventions in cancer
Psycho-Oncology, 2014
Objective-The purpose of this study was to test for moderating effects of patient characteristics on self-management interventions developed to address symptoms during cancer treatment. Patient's age, education and depressive symptomatology were considered as potential moderators. Methods-A secondary analysis of data of 782 patients from two randomized clinical trials was performed. Both trials enrolled patients with solid tumors undergoing chemotherapy. After completing baseline interviews, patients were randomized to a nurse-delivered intervention versus intervention delivered by a "coach" in trial I, and to a nurse-delivered intervention versus an intervention delivered by an automated voice response system in trial II. In each of the two trials, following a 6-contact 8-week intervention, patients were interviewed at week 10 to assess the primary outcome of symptom severity. Results-While nurse-delivered intervention proved no better than the "coach" or automated system in lowering symptom severity, important differences in the intervention by age were found in both trials. Patients ≤45 years responded better to the "coach" or automated system; while those ≥75 years favored the nurse. Education and depressive symptomatology did not modify the intervention effects in either of the two trials. Depressive symptomatology had a significant main effect on symptom severity at week 10 in both trials (p=.03 and p<.01, respectively). Education was not associated with symptom severity over and above age and depressive symptomatology. Conclusions-Clinicians need to carefully consider the age of the population when using or testing interventions to manage symptoms among cancer patients.
Psycho-oncology, 2018
Objective: Patients receiving treatment for advanced cancer suffer significant symptom burden, including co-occurring pain, fatigue, and sleep disturbance. There is limited evidence for effective interventions targeting this common symptom cluster. Methods: A randomized controlled trial of a brief cognitive-behavioral strategies (CBS) intervention was conducted. A sample of 164 patients with advanced cancer receiving chemotherapy practiced imagery, relaxation and distraction exercises or listened to cancer education recordings (attention-control) to manage co-occurring pain, fatigue, and sleep disturbance over a 9-week period. Symptom cluster severity, distress, and interference with daily life were measured at baseline and 3-, 6-, and 9-weeks. We also evaluated the moderating influence of imaging ability and number of concurrent symptoms, and mediating effects of changes in stress, anxiety, outcome expectancy, and perceived control over symptoms. Results: Compared to the cancer education condition, participants receiving the CBS intervention reported less symptom cluster distress at week 6 (M=1.82 vs. 2.15 on a 0-4 scale, p < .05). No other group differences were statistically significant. The number of concurrent symptoms moderated the intervention effect on symptom cluster interference. Changes in stress, outcome expectancy and perceived control mediated the extent of intervention effects on symptom outcomes, primarily at weeks 6 and 9. Conclusions: The brief CBS intervention had limited effects in this trial. However, findings regarding potential mediators affirm hypothesized mechanisms and provide insight into ways to The authors have no conflicts of interest to declare.
2021
BackgroundCancer is a worldwide common illness, it evokes psychological distress at different stages, during chemotherapy patient perceives a variety of psychiatric symptoms due to various medication side-effects and psychological distress. Studies have shown a significant impact of CBT in the management of psychiatric symptoms during chemotherapy. This study aims to investigate the effectiveness of CBT for depression, anxiety, stress, death anxiety, satisfaction with life, and self-esteem among cancer patients during chemotherapy (CPdC).MethodsPlace and duration of the study: Department of Applied Psychology, Government College University Faisalabad in collaboration with Department of Oncology, Allied Hospital Faisalabad from November 20, 2020 and July 31, 2021. A total of 90 cancer patients were enrolled. 70 out of 90 met the eligibility criteria and 60 participants fulfilled all requirements. Participants were randomly allocated to four different groups. The pre-assessment screen...
The efficacy of behavioral interventions for cancer treatment-related side effects
Seminars in clinical neuropsychiatry, 2003
The use of increasingly aggressive methods of cancer treatment (e.g., cytotoxic doses of chemotherapy and total body irradiation) has resulted in the need for more effective management of pain, nausea, and other aversive side effects. One of the most promising approaches is nonpharmacologic intervention based on behavioral research and theory. The purpose of this article is to review the efficacy of behavioral intervention methods in controlling aversive side effects of cancer treatments. Sixty-seven published studies were identified for review. Results indicated that: (1) behavioral intervention can effectively control anticipatory nausea and vomiting in adult and pediatric patients undergoing cancer chemotherapy. However, evidence for the efficacy of behavioral intervention to control post-chemotherapy nausea and vomiting is mixed; (2) behavioral intervention integrating several behavioral techniques can decrease levels of anxiety and distress associated with invasive treatments a...
Effect on symptom control of structured information given to patients receiving chemotherapy
European Journal of Oncology Nursing, 2014
Purpose: The performance of a planned education model in patients receiving chemotherapy can alleviate the side effects of chemotherapy and thus can increase the quality of the patients' lives. In accordance with this view, this study was conducted with the purpose of examining the effect of planned education given to patients receiving chemotherapy on their symptom control. Methods: The study was quasi-experimental. A sample of 120 patients participated, of which 60 were in the experimental group (EG) and 60 were in the control group (CG). A patient data form and the chemotherapy symptom assessment scale (C-SAS) were used in order to collect the data. Median, ManneWhitney U test and Wilcoxon signed rank test were used to analyze the data. Results: There were statistically significant decreases in the frequencies of the following symptoms: nausea, vomiting, constipation, pain, infectious signs, problems of mouth and throat, problems of skin and nails, appetite changes, weight loss or weight gain, feeling distressed/anxious, feeling pessimistic and unhappy, unusual fatigue, difficulty sleeping. Also, there were statistically significant decreases in the severity of eleven symptoms and on the discomfort levels of nine symptoms. Conclusion: In the study, the planned education provided by the health-care providers had a positive effect on the symptom control of patients receiving chemotherapy.