Freeman, L.W., White, R., Ratcliff, C.G., Sutton, S., Stewart, M., Palmer, J.L., . . . Cohen, L. (2014). A randomized trial comparing live and telemedicine deliveries of an imagery-based behavioral intervention for breast cancer survivors: Reducing symptoms and barriers to care. Psycho-Oncology. Advance online publication.
To determine the effects of guided imagery training on quality of life (QOL) for survivors of breast cancer
Trained professionals facilitated five weekly live (LD) or teleconference (TD) group sessions. The initial four sessions each included four one-hour modules of training in guided imagery (i.e., four hours per week). Each module was divided equally between a didactic lesson and an interactive small group activity. Didactic lessons provided education on the mind-body connection, particularly the influence of mental imagery and corresponding sensory experiences on physiologic processes. Small group activities incorporated opportunities to process lessons and to practice active and targeted imagery aimed at improving QOL. Each week, participants were given a guided imagery CD to reinforce current lessons and to promote the practice of imagery techniques daily. The fifth week provided a final group check-in for individuals to share their future plans for incorporating imagery into daily life. Weekly calls were made to encourage daily practice during the intervention and for three months postintervention. Waitlist controls (WLs) received no intervention. Outcome measures were assessed before the behavioral intervention and at one and three months after the intervention.
Randomized, waitlist-controlled trial
Both intervention groups (LD and TD) reported better cognitive function, less fatigue, and less sleep disturbance than waitlist controls (p < .01 for both). The LD and TD groups did not differ in any outcomes. No group effects were found for the other QOL outcomes. No time or group-by-time effects were found for any outcomes. A smaller portion of LD and TD participants reported clinically meaningful sleep disturbances (p < .01 for both) and fatigue (p < .05 for both) at the follow-up assessments.
After five weeks, the group guided imagery course provided by a trained facilitator may improve patient-reported cognitive impairment, sleep disturbances, and fatigue in breast cancer survivors. The delivery of this intervention in person or via teleconference produced the same results, suggesting that the intervention may be appropriate for use in telemedicine.
A group guided imagery course, delivered live or via teleconference by a trained facilitator, may improve cognitive impairment, sleep disturbance, and fatigue for breast cancer survivors. However, more research with larger samples and a longer follow-up is warranted to determine whether the intervention is effective and practical.