Outcomes of an uncertainty management intervention in younger African American and Caucasian breast cancer survivors

Abstract

Purpose/objectives: To determine whether breast cancer survivors (BCSs) who received an uncertainty management intervention, compared to an attention control condition, would have less uncertainty, better uncertainty management, fewer breast cancer-specific concerns, and more positive psychological outcomes.

Design: A 2 × 2 randomized block, repeated-measures design, with data collected at baseline and two other points postintervention, as well as a few days before or after either a mammogram or oncologist visit.

Setting: Rural and urban clinical and community settings.

Sample: 313 female BCSs aged 50 or younger; 117 African Americans and 196 Caucasians.

Methods: Participants were blocked on ethnicity and randomly assigned to intervention or control. The intervention, consisting of a scripted CD and a guide booklet, was supplemented by four scripted, 20-minute weekly training calls conducted by nurse interventionists. The control group received the four scripted, 20-minute weekly training calls.

Main research variables: Uncertainty in illness, uncertainty management, breast cancer-specific concerns, and positive psychological outcomes.

Findings: BCSs who received the intervention reported reductions in uncertainty and significant improvements in behavioral and cognitive coping strategies to manage uncertainty, self-efficacy, and sexual dysfunction.

Conclusions: The intervention was effective as delivered in managing uncertainties related to being a younger BCS.

Implications for nursing: The intervention can realistically be applied in practice because of its efficient and cost-effective nature requiring minimal direct caregiver involvement. The intervention allows survivors who are having a particular survival issue at any given point in time to access information, resources, and management strategies.

Knowledge translation: Materials tested in CD and guide booklet format could be translated into online format for survivors to access as issues arise during increasingly lengthy survivorship periods. Materials could be downloaded to a variety of electronic devices, fitting with the information needs and management styles of younger BCSs.