Evaluation of "Steps to Surgical Success" (STEPS): a holistic perioperative medicine program to manage pain and anxiety related to surgery.

This empirical study found that a holistic perioperative program significantly reduced patient pain and anxiety about surgery. Modalities included guided imagery, eye pillow, aromatherapy, and a written personal healing plan. Nurses are in a prime position to deliver these interventions, given their frequent direct contact with patients.

What do I have to lose? Effects of a psycho-educational intervention on cancer patient preference for resuscitation.

This original empirical study examined effects of a psycho-educational intervention on cancer patients' knowledge, concern, and preferences for cardiopulmonary resuscitation (CPR). We examined message framing as one factor that might impact subsequent decision making. In addition, we examined personality and coping style as predictors and moderators of patients' reactions to an informational intervention. As hypothesized, participants initially underestimated CPR complications and overestimated survival rates. The intervention significantly increased concern, improved knowledge, and decreased preference for CPR, particularly for participants receiving both numerical and descriptive information. Message framing of survival data did not uniquely affect CPR preference. Higher optimism predicted less increase in concern about CPR, and higher hope predicted greater decrease in preference for CPR. More approach coping related to increased concern about CPR and decreased preference for CPR.

Promoting adjustment after treatment for cancer.

The transition from the period of diagnosis and medical treatment of cancer to survivorship (i.e., the reentry phase) is an understudied phase in the cancer trajectory. The objectives of this report were 1) to illustrate several adaptive tasks of the reentry phase, 2) to provide examples of research on factors that predict positive adjustment during this phase, and 3) to discuss interventions that address the adaptive tasks of early cancer survivorship. Although the pertinent empirical literature is scarce, accounts from cancer survivors, healthcare professionals, and qualitative researchers converge to suggest several themes in adaptive tasks during reentry. Drawing from the authors' work and that of others, the authors have described common expectancies held by many individuals approaching reentry (e.g., "I shouldn't need support"), typical concerns during this phase (e.g., concern over cancer recurrence), and personal and contextual factors that can facilitate and hinder adjustment. Promising psychosocial interventions have been developed for individuals in the reentry period. Continued research will be necessary to characterize this important phase of cancer survivorship.

The yellow brick road and the emerald city: benefit finding, positive reappraisal coping and posttraumatic growth in women with early-stage breast cancer.

Predictors and outcomes of benefit finding, positive reappraisal coping, and posttraumatic growth were examined using interviews and questionnaires from a longitudinal study of women with early-stage breast cancer followed from primary medical treatment completion to 3 (n=92) and 12 months (n=60) later. Most women (83%) reported at least 1 benefit of their breast cancer experience. Benefit finding (i.e., identification of benefits, number of benefits), positive reappraisal coping, and posttraumatic growth had distinct significant predictors. Positive reappraisal coping at study entry predicted positive mood and perceived health at 3 and 12 months and posttraumatic growth at 12 months, whereas benefit finding did not predict any outcome. Findings suggest that benefit finding, positive reappraisal coping, and posttraumatic growth are related, but distinct, constructs.

Recruitment and retention challenges in breast cancer survivorship research: results from a multisite, randomized intervention trial in women with early stage breast cancer.

The Moving Beyond Cancer trial is a multisite randomized, controlled trial of an individualized psychoeducational intervention for women with early stage breast cancer. Recruitment early in the cancer trajectory and assessment of retention at multiple points are notable features of the research, offering a unique opportunity to examine recruitment, retention, and predictors of participation. Patients were registered for the study within 6 weeks after definitive surgery and followed until primary medical treatment completion, whereupon they were enrolled, administered baseline measures, and randomized to one of three arms. Of 2,242 women referred, 41% were ineligible. Of eligible women, 42% elected participation through the point of randomization (n = 558). Participants did not differ from nonparticipants on initial self-reported physical functioning and mental health status, employment status, cancer history, cancer treatment plan, or previous cancer-related research participation. Women who were over 65 years of age, of racial minority status, unmarried, or less educated were less likely to participate through the point of randomization. Thus, several patient characteristics predicted trial participation, indicating the need for targeted recruitment attempts.