ABSTRACT
The range of effects of psychosocial interventions on quality of life among women with breast cancer remains uncertain. Furthermore, it is unclear which components of multimodal interventions account for such effects. To address these issues, the authors tested a 10-week group cognitive-behavioral stress management intervention among 199 women newly treated for nonmetastatic breast cancer, following them for 1 year after recruitment. The intervention reduced reports of social disruption and increased emotional well-being, positive states of mind, benefit finding, positive lifestyle change, and positive affect for up to 12 months (indeed, some effects strengthened over time). With respect to mechanisms tested, the intervention increased confidence in being able to relax at will. There was also evidence that effects of the intervention on the various outcomes examined were mediated by change in confidence about being able to relax. Thus, this intervention had beneficial effects on diverse aspects of quality of life after treatment for breast cancer, which appear linked to a specific stress management skill taught in the intervention.
Subject(s)
Breast Neoplasms/psychology , Cognitive Behavioral Therapy/methods , Psychotherapy, Group/methods , Quality of Life/psychology , Relaxation Therapy , Stress, Psychological/complications , Adaptation, Psychological , Adult , Aged , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Middle Aged , Sick Role , Stress, Psychological/psychologyABSTRACT
OBJECTIVE: After surgery for breast cancer, many women experience anxiety relating to the cancer that can adversely affect quality of life and emotional functioning during the year postsurgery. Symptoms such as intrusive thoughts may be ameliorated during this period with a structured, group-based cognitive behavior intervention. METHOD: A 10-week group cognitive behavior stress management intervention that included anxiety reduction (relaxation training), cognitive restructuring, and coping skills training was tested among 199 women newly treated for stage 0-III breast cancer. They were then followed for 1 year after recruitment. RESULTS: The intervention reduced reports of thought intrusion, interviewer ratings of anxiety, and emotional distress across 1 year significantly more than was seen with the control condition. The beneficial effects were maintained well past the completion of adjuvant therapy. CONCLUSIONS: Structured, group-based cognitive behavior stress management may ameliorate cancer-related anxiety during active medical treatment for breast cancer and for 1 year following treatment. Group-based cognitive behavior stress management is a clinically useful adjunct to offer to women treated for breast cancer.
