Improving Outcomes for Rural Survivors of Breast Cancer: Supplement for Pennsylvania

  • Wyatt, Stephen (PI)

Grants and Contracts Details

Description

Subcontract to Pennsylvania State University, Pilot project: Although women with breast cancer who complete treatment are technically considered "survivors," studies suggest that mental and physical distress can persist for years after active therapy has ended. One important adjunct in the care of persons with cancer is psychosocial support, which can improve emotional and, in some cases, physiological function. However, in rural areas such as Appalachia, the availability of these kinds of services has been identified as problematic for breast cancer survivors. For this reason, women from Appalachia are at-risk for adverse short and long term outcomes from breast cancer. Therapeutic writing with the intent of emotion expression is a structured psychological intervention that has been studied for two decades with a variety of "well" populations. Recently, an investigation using medically ill patients documented that this strategy could improve both physical and psychological parameters of health for patients with arthritis and asthma. Therapeutic writing is a robust and practical approach to providing emotional support, and is not dependent on Irteracy or other patient characteristics. Therefore, the goal of this randomized clinical trail is to test the impact of a therapeutic writing/emotion expression intervention on the health of breast cancer survivors residing within the NALIC area. All adult patients who are Stage I, II, or III, will be eligible to participate. The desired final sample size is 100 participants who will be randomly assigned into a therapeutic writing (writing about stressful experiences) or neutral writing (wrrting about neutral topics) group. The writing sessions will take place during one week in which participants will be asked to wrrte for four consecutive days, 20 minutes per session. The treatment group will be directed to do emotionally expressive therapeutic writing while the control group will write on neutral topics. Data will be collected via telephone interview four times: at baseline, one week later when the writing intervention is begun, the week after the writing intervention takes place, and two weeks after the writing intervention. A battery of instruments will be used to collect information on the outcomes of interest: medical status, mood, depression, quality of life, stress, coping, social support, and fatigue . Appropriate statistical techniques will be used to test the hypothesis that treatment group subjects will demonstrate significantly improved mental and physical outcomes. Co-variates will include age, length of time off-treatment, type of treatment, and use of concurrent psychoactive medications or psychotherapy, as well as any other factors that emerge in the preliminary analyses as significant influences. The findings of this research will have relevance for both breast cancer survivors in rural areas such as the Appalachia cancer network, the larger population of persons afflicted with terminal diseases, and other residents of rural areas who may require emotional support. The use of practical and effective interventions that improve physical and psychological outcomes for all these groups.
StatusFinished
Effective start/end date5/20/043/31/06

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