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Can telephone counseling post‐treatment improve psychosocial outcomes among early stage breast cancer survivors?
Author(s) -
Marcus Alfred C.,
Garrett Kathleen M.,
Cella David,
Wenzel Lari,
Brady Marianne J.,
Fairclough Diane,
PateWillig Meredith,
Barnes Denise,
Powell Emsbo Susan,
Kluhsman Brenda C.,
Crane Lori,
Sedlacek Scot,
Flynn Patrick J.
Publication year - 2010
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.1653
Subject(s) - psychosocial , medicine , telephone counseling , distress , breast cancer , depression (economics) , referral , randomized controlled trial , intervention (counseling) , physical therapy , cancer , psychiatry , family medicine , clinical psychology , economics , macroeconomics
Abstract Objective : To determine whether a telephone counseling program can improve psychosocial outcomes among breast cancer patients post‐treatment. Methods : A randomized trial was conducted involving 21 hospitals and medical centers, with assessments (self‐administered questionnaires) at baseline, 12 and 18 months post‐enrollment. Eligibility criteria included early stage diagnosis, enrollment during last treatment visit, and the ability to receive the intervention in English. Endpoints included distress (Impact of Event Scale), depression (Center for Epidemiologic Studies Depression Scale), and two study‐specific measures: sexual dysfunction and personal growth. The control group ( n =152) received a resource directory for breast cancer; the intervention group ( n =152) also received a one‐year, 16 session telephone counseling program augmented with additional print materials. Results : Significant intervention effects were found for sexual dysfunction at 12 ( p =0.03) and 18 months ( p =0.04) and personal growth (12 months: p =0.005; 18 months: p =0.03). No differences by group were found in mean scores for distress and depression, with both groups showing significant improvement at 12 and 18 months (all p values for within‐group change from baseline were ⩽0.003). However, when dichotomized at cutpoints suggestive of the need for a clinical referral, the control group showed virtually no change at 18 months, whereas the intervention group showed about a 50% reduction in both distress ( p =0.07) and depression ( p =0.06). Conclusions : Telephone counseling may provide a viable method for extending psychosocial services to cancer survivors nationwide. Copyright © 2010 John Wiley & Sons, Ltd.