Stress Management in Breast Cancer Patients
How Can Health Care Help Female Breastcancer Patients Reduce Their Stress Symptoms? A Randomized Intervention Study With Stepped-care
The purpose of this study within Caring sciences is to identify women with breast cancer who have stress symptoms and to offer these women appropriate care to reduce stress and increase well-being. This will be achieved by
- Studying the prevalence of stress related symptoms in female patients with breast cancer
- Testing the use of two short screening instruments to identify women at risk for developing long-standing stress symptoms
- Studying the level and intensity of stress management interventions required to achieve increased well-being, using a stepped-care approach.
- Studying the effects of interventions based on cognitive behavior therapy, delivered individually or in a group format.
The hypothesis is that half of the individuals assigned to a low intensity intervention will be significantly improved after treatment. For individuals who continue to have symptoms after low intensity treatment it is hypothesized that continued treatment in a group setting with high intensity interventions will be more cost-effective. In addition the assumption is that reduction of stress symptoms in women with breast cancer will lead to a reduction in socio-economic costs.
調査の概要
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Falun、スウェーデン
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Gävle、スウェーデン
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Uppsala、スウェーデン
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- over the age of 18
- a recent diagnosis of breast cancer
- scheduled for adjuvant treatment in Falun, Gävle or Uppsala (Sweden)
Exclusion Criteria:
- ongoing psychiatric condition
- language deficiencies in Swedish
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:Stress management Individual format
The methods and techniques will be the same as those used in the group intervention.
The first session will be used for a detailed assessment of the individual's psychosocial problems, as used in earlier studies.
The sessions will last 45 - 60 minutes.
The number of sessions will depend on the individual patient's problems and the joint assessment made by the patient and nurse together.
The total number of sessions will be at least 4, with a maximum of 8.
The contents of the sessions are Session 1: Assessment, Session 2: Analysis of diary (self-registration) and suggestions for problem management, Session 3: Evaluation of problem management skills Session 4: Follow-up and conclusion of the intervention.
When necessary Sessions 5 -8 will address specific obstacles and continued practice.
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All patients start at the first step of the intervention program with a two hours psychoeducation in stress management.
Patients, who don't report a decrease in stress related symptoms, after the first step will be offered an intensive stress management, either in individual or group format.
Components included in the intervention concern 1) basic knowledge about cancer, treatment, healthy living and stress reactions, 2) self-awareness with help of diary for thoughts, feelings and behavior 3) instruction in various techniques on how to express negative feelings, how to communicate with others more effectively, how to change behaviors related to stress 4) training these techniques in real-life situations 5) cognitive restructuring 6) spirituality, derived from cognitive behavior therapy.
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実験的:Stress management Group format
Participants will meet for 2 hours every week for a total of 20 hours.
In the intervals between the group meetings patients will be asked to do homework.
Homework entails practicing problem-solving techniques, keeping a diary, practicing relaxation or physical activities.
Each group meeting has a specific subject, i.e.
What is stress and stress behaviors, Stress related symptoms, How to manage anger and negative thoughts, Self-registrations and behavioral changes, Future perspectives, Cancer, stress and relations, Expectations and demands, Body, pleasure and sexuality.
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All patients start at the first step of the intervention program with a two hours psychoeducation in stress management.
Patients, who don't report a decrease in stress related symptoms, after the first step will be offered an intensive stress management, either in individual or group format.
Components included in the intervention concern 1) basic knowledge about cancer, treatment, healthy living and stress reactions, 2) self-awareness with help of diary for thoughts, feelings and behavior 3) instruction in various techniques on how to express negative feelings, how to communicate with others more effectively, how to change behaviors related to stress 4) training these techniques in real-life situations 5) cognitive restructuring 6) spirituality, derived from cognitive behavior therapy.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Psychosocial aspect
時間枠:Changes in psychosocial aspects from baseline to 12 months post diagnosis
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Intrusion, Avoidance, Anxiety, Depression, Quality of life, Fatigue, Daily stress
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Changes in psychosocial aspects from baseline to 12 months post diagnosis
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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Cost-Utility Analysis
時間枠:12 month
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12 month
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Patient satisfaction
時間枠:3 month, after intensive intervention and 12 month
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3 month, after intensive intervention and 12 month
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協力者と研究者
スポンサー
捜査官
- 主任研究者:Karin Nordin, Prof、Uppsala University
出版物と役立つリンク
一般刊行物
- Hellerstedt-Borjesson S, Nordin K, Fjallskog ML, Holmstrom IK, Arving C. Women Treated for Breast Cancer Experiences of Chemotherapy-Induced Pain: Memories, Any Present Pain, and Future Reflections. Cancer Nurs. 2016 Nov/Dec;39(6):464-472. doi: 10.1097/NCC.0000000000000322.
- Nordin K, Rissanen R, Ahlgren J, Burell G, Fjallskog ML, Borjesson S, Arving C. Design of the study: how can health care help female breast cancer patients reduce their stress symptoms? A randomized intervention study with stepped-care. BMC Cancer. 2012 May 4;12:167. doi: 10.1186/1471-2407-12-167.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。