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Effect of neutropenia on the impact of a cognitive‐behavioral intervention for symptom management
Author(s) -
Given Barbara A.,
Given Charles W.,
Jeon Sanchoon,
Sikorskii Alla
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21240
Subject(s) - medicine , neutropenia , randomized controlled trial , psychological intervention , physical therapy , quality of life (healthcare) , chemotherapy , psychiatry , nursing
BACKGROUND Trials of cognitive‐behavioral interventions (CBI) designed to reduce symptom severity or improve dimensions of quality of life seldom consider how the side effects of treatment or the complications imposed by the disease or treatment may moderate the impact of the trial on the designated outcome. To address this issue, the moderating effect of neutropenia on the impact of a CBI for reducing symptom severity was evaluated among patients with cancer undergoing chemotherapy. METHODS The authors described the impact of a randomized trial of a 10‐contact, 20‐week CBI on symptom severity, as well as the moderating effect of a neutropenic episode on symptom severity at 20 weeks. Severity scores were based on sum scores (0–10) for 15 symptoms. RESULTS There was an effect for age (younger) and group on severity at 20 weeks and an interaction between neutropenia and group. Among patients with no evidence of neutropenia, those in the experimental arm had a 9‐point lower severity score at 20 weeks. Among patients who experienced neutropenia, differences in symptom severity by arm of the trial were < 3 points. Further, fatigue, fever, and pain were more prevalent among patients with neutropenia. CONCLUSIONS Patients who experienced neutropenia did not benefit from a CBI to lower symptoms. The overall effect of this intervention came almost exclusively from patients without neutropenia. Cancer 2005. © 2005 American Cancer Society.