ABSTRACT
PURPOSE/OBJECTIVES: To test the feasibility and acceptability of an individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors and test the short-term effects of an IRIS on symptom distress. DESIGN: Two small randomized clinical trials and one pre-experimental study. SETTING: Oncology clinic and community. SAMPLE: 41 women with breast cancer (aged 65 years and older) in pilot study 1, 20 in pilot study 2, and 21 in pilot study 3. METHODS: In pilot study 1, women were randomized to the IRIS or usual care control. In pilot study 2, women were randomized to the IRIS or delayed IRIS (wait list) control. In pilot study 3, all women received the IRIS by telephone. Measures were collected at baseline, postintervention, and follow-up (up to four months). MAIN RESEARCH VARIABLES: Feasibility, acceptability, symptom distress, symptom management behaviors, symptom management barriers, and quality of life. FINDINGS: Across three pilot studies, 76% of eligible women participated, 95% completed the study, 88% reported the study was helpful, and 91% were satisfied with the study. Some measures of symptom distress decreased significantly after the IRIS, but quality of life was stable. Women in the IRIS group changed their symptom management behaviors more than controls. CONCLUSIONS: Preliminary evidence supports the need for and feasibility of an IRIS. IMPLICATIONS FOR NURSING: Nurses may help older breast cancer survivors manage their numerous chronic symptoms more effectively by assessing women's beliefs about their symptoms and their current symptom management strategies.
Subject(s)
Breast Neoplasms/nursing , Breast Neoplasms/psychology , Oncology Nursing/methods , Quality of Life , Telephone , Affective Symptoms , Aged , Anxiety/prevention & control , Feasibility Studies , Female , Follow-Up Studies , Humans , Nurse-Patient Relations , Pilot Projects , Severity of Illness IndexABSTRACT
PURPOSE/OBJECTIVES: To compare symptoms, symptom beliefs, and quality of life (QOL) of older breast cancer survivors to those of older women without breast cancer. DESIGN: Descriptive, correlational study. SETTING: Urban and rural communities in the Midwest United States. SAMPLE: 18 breast cancer survivors and 24 women without breast cancer, older than age 64 (X age = 76 years). METHODS: In-home interviews using structured instruments. MAIN RESEARCH VARIABLES: Symptom distress (number of and distress from symptoms), symptom beliefs, chronic health problems, and QOL. FINDINGS: No group differences existed in demographic characteristics, symptom number, symptom bother, chronic health conditions, or QOL. Women in both groups most often attributed the cause of their symptoms to aging, chronic illness, or unknown, but rarely to breast cancer. Attributing symptoms to chronic illness or breast cancer was significantly related to more pain, depression, role impairment, and poorer mental health. Not knowing the cause of symptoms was significantly related to poorer social functioning, mental health, and purpose in life; less energy; and higher levels of depression and anxiety. CONCLUSIONS: The symptom experience and QOL of older breast cancer survivors are similar to those of older women with other chronic health problems. Beliefs about symptoms influence QOL in older women. IMPLICATIONS FOR NURSING: A broader assessment of symptoms is needed to assist older breast cancer survivors with symptom management. Symptom interventions in older women should address patients' beliefs about symptoms if QOL is to be enhanced.
