Developing and Testing the Effects of a Psychosocial Intervention on Stress Response and Coping in Korean Breast Cancer Survivors : A Pilot Study

유방암 환자의 스트레스 대응 능력 증진을 위한 심리사회적 중재 재발 및 효과: 예비연구

  • Published : 2004.10.01

Abstract

Purpose: The purpose of this study was to develop a socioculturally-appropriate psychosocial intervention program for Korean patients with breast cancer and test its effects on stress, anxiety, depression, and coping strategies. Methods: One group pretest and posttest design was used to test the effects of the intervention. A post-intervention interview was conducted to refine the nature of the intervention. A convenience sample of 10 breast cancer survivors was recruited from the outpatients clinics. Psychosocial intervention was developed to provide the health education, stress management, coping skill training and support weekly(90min) for 6 weeks. Results: There was a significant decrease in stress scores following the intervention(Z= -2.388, p=0.017). However, no significant changes were noted in the use of problem-focused and emotion-focused coping strategies, nor in the changes of anxiety and depression levels. Content analysis of interview data revealed six clusters; changes in perception, changes in problem solving approaches, changes in anger management, changes in life pattern, social support and reduction of perceived stress. Conclusions: Based on quantitative and qualitative data, we recommend the refinements of the intervention in the following areas for future studies: 1) duration, activities, and progression of psychosocial intervention; 2) research design and sample size; and 3) measurements.

Keywords

References

  1. Bordeleau, L., Szalai, J. P., Ennis, M., Leszcz, M., Speca, M., Sela, R., Doll, R., Chochinov, H. M., Navarro, M., Arnold, A., Pritchard, K. I., Bezjak, A., Llewellyn- Thomas, H. A., Sawka, C. A., & Goodwin, P. J. (2001). Quality of life in a randomized trial of group psychosocial support in metastatic breast cancer: overall effects of the intervention and an exploration of missing data. J Clin Oncol, 21(10), 1944-1951
  2. Fawzy, F. I., Fawzy, N. W., Kemeny, M. E., Elashoff, R., & Morton, D.(1990). A structured psychiatric intervention for cancer patients. I. Changes overtime in methods of coping and affective disturbance. Arch Gen Psychiatry, 47, 720-725
  3. Fawzy, F. I., & Fawzy, N. W. (1994). A structured psychoeducational interventions for cancer patients. Gen Hasp Psychiatry, 16, 149-192 https://doi.org/10.1016/0163-8343(94)90098-1
  4. Fawzy, F. I., Fawzy, N. W., Arndt, N. W., Pasnau, R. O. (1995). Critical review of psychosocial intervention in cancer care. Arch Gen Psychiatry, 52, 100-113
  5. Folkman, S. & Lazarus, R. S. (1986). Stress processes and depressive symptomatology. J Abnorm Psycho, 95(2), 107-113
  6. Fukui, S., Kamiya, M., Koike, M., Kugaya, A., Okamura, H., Nakanishi, T., Imoto, S., Kanagawa, K., & Uchitomi, Y. (2000). Applicability of a western-developed psychosocial group intervention for Japanese patients with primary breast cancer. Pschooncology, 9, 169-177 https://doi.org/10.1002/(SICI)1099-1611(200003/04)9:2<169::AID-PON441>3.0.CO;2-V
  7. Fukui, S., Koike, M., Ooba, A., & Uchitomi, Y. (2003). The effect of psychosocial group intervention on loneliness and social support for Japanese women with primary breast caner. Oncol Nurs Forum, 30(5), 823-830
  8. Graves, K. D. (2003). Social cognitive theory and cancer patients' quality of life: A meta analysis of psychological intervention components. Health Psychol, 22(2), 210-219
  9. Hur, H. K., & Kim, D. R. (1999). The lived experiences of patients with breast cancer in Korea. J Wonju Coli Med, 12(1), 105-116
  10. Hwang, S. K., Park, B. W., & Lee, K. S. (2000). A preliminary study of psychoeducational support group program for breast cancer patients. Social Welfare Study, 15, 291-310
  11. Hwang, S. K., Park, B. W., & Lee, K. S. (2001). A psychosocial support program for women with primary breast carcinoma. J Korean Acad Surg, 61(4), 357-363
  12. Kang, D. (2001). Psychoneuroimmunology: the past, the present, and the future. Report of the annual memorial conference of the Maple Professor, Yonsei University
  13. Keller, M. (1994). Results concerning the efficacy of psychotherapeutic intervention. In G. Schrittmatter (Ed), Ethics in oncology. Report of the 12th annual conference of the Germany society for psychooncology
  14. Kiecolt-Glaser, J. K., & Glaser, R. (1988). Behavioral influence on immune function: Evidence for the interplay between stress and health. In T. Field, P. McCabe, & N. Schneiderman (Eds), Stress and coping (Vol 2, pp. 186-206). NJ: Erlbaum
  15. Kim C. J., Hur, H. K., Kang, D. H., & Kim, B. H.(2004). Effects of psychosocial stress management on stress and coping in student nurses. J Korean Acad Adult Nurs, 16(1), 90-101
  16. Kim, B. R., Kim, Y. H., Kim, J. S., Jeong, J. S., & Kim, J. S.(2003). A study to the coping patterns of cancer patients. J Korean Acad Nurs, 33(3), 321-330
  17. Kwan, I. G., Park, E. Y., Ham, Y. H., Rhoo, S. S., & Lee, E. O. (2001). Effects of the self-help group program for promoting self-transcendence in women with breast cancer. J Korean Onco Nurs, 1(2), 217-228
  18. Levy, S. M., Herberman, R. 8., Whiteside, T., Sanzo, K., Lee, J. & Kirkwood, J. (1990). Perceived social support and tumor estrogen/progesterone receptor status as predictors of natural killer cell activity in breast cancer patients. Psychol Med, 52, 73-85
  19. Maddux, J. E., & Lewis, J. (1995). Self-efficacy and adjustment: Basic principles and issues. In J. E. Maddux (Eds.), Self efficacy, adaptation, and adjustment: Theory, research and applicationtpp(pp. 37-68). NY: Plenum Press
  20. Meyer, T. J., & Mark, M. M. (1995). Effects of psychosocial interventions with adult cancer patients: A meta analysis of randomized experience. Health Psychol, 14, 101-108 https://doi.org/10.1037/0278-6133.14.2.101
  21. Muthny, A. A. (1998). Psychology, need, measures and effects exemplified by the Herford models. Lengerrich: Pabst Science Pub
  22. Nezu, A. M., Nezu, C. M., Feiedman, S. H., Faddis, S. & Houts, P. S. (1988). Helping cancer patients cope: A problem-solving approach. Washington, DC.: American Psychological Association
  23. Rawl, S. M., Given, B. A., Given, C. W., Champion, V. L., Kozachik, S. J., Barton, D., Ernsley, C. J., & Williams, S. D. (2002). Intervention to improve psychological functioning for newly diagnosed patients with cancer. Oncol Nurs Forum, 29(6), 967-975
  24. Rehse, B., & Pukrop, R. (2003). Effects of psychosocial interventions on quality of life in adult cancer patients: meta analysis of 37 published controlled outcome studies. Pat Edu and Counselling, 50(2), 179-186
  25. Ryu, E. J. (2001). Depression, self efficacy and coping in patients with cancer. J Korean Acad Adult Nurs, 13(1), 70-81
  26. Shin, K. R. (2001). Depression among korean women. J Korean Acad Nurs, 31(3), 391-400
  27. So, H. S. (1995). Changes on the uncertainty, ways of coping and depression for patients with uterine cervical cancer during the early adaptation process: A longitudinal study Unpublished doctoral dissertation. Yonsei Univ of Korean, Seoul
  28. Spiegel, D., Bloom, J., Kraemer, H. c., & Gottheil, E. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 14, 888-891