Study Purpose
The intervention was cognitive- existential therapy (CEGT) provided in 9 Australian hospitals.
Intervention Characteristics/Basic Study Process
Existential themes of anxiety about death and uncertainty incorporated into six goals of therapy: promoting supportive environment; facilitating grief work over multiple losses, altering maladaptive cognitive patterns, enhancing problem solving and coping skills, fostering a sense of mastery, and sorting out priorities for future.
Sample Characteristics
Randomized controlled trial; longitudinal study
303 women with stage I or II breast cancer stratified by nodal status, hormone receptor status and tumor size.
Intervention group: CEGT + 3 relaxation classes. N=154
Control group: 3 relaxation classes. N=149
Measurements taken at baseline, 6 months, and 12 months after the intervention.
Setting
The intervention was offered by 15 therapists recruited from psychiatry, psychology, social work, Occupational Therapy and oncology nursing staff. All therapists received specialized training and supervision through a series of workshops using 68- page manual.
Phase of Care and Clinical Applications
Monash Interview for Liaison Psychiatry-structured psychiatric interview validated with DSM-IIIR
Affect Balance Scale
Study Design
The intervention was offered by 15 therapists recruited from psychiatry, psychology, social work, Occupational Therapy and oncology nursing staff. All therapists received specialized training and supervision through a series of workshops using 68- page manual.
Measurement Instruments/Methods
Hospital Anxiety & Depression Scale (HADS)
Mental Adjustment to Cancer Scale (MAC)
Family Assessment Device
Satisfaction with therapy and other treatments.
Results
Baseline screening showed 1/3 of entire sample of women suffered from a form of depressive disorder
Reduced anxiety (p=0.05, 2 sided)
Conclusions
Overall effect size for group intervention was small (d=0.25).
Conclusions: use the CEGT model for patients with early breast cancer and use supportive- expressive treatment model for patients with advanced breast cancer.
Limitations
Minor design flaw: both groups received three relaxation classes.
Nursing Implications
Psychologist intervention group had moderate mean effect size (d=0.52)—training and experience of therapist makes the intervention more effective.
Specialized training needs for therapists.