Congress Abstracts 2004

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INTERVENTIONS CURRENTLY RECOMMENDED TO ALLEVIATE SYMPTOMS CAUSING DISTRESS IN WOMEN WITH BREAST CANCER MAY PROVE INEFFECTIVE BECAUSE OF ADVERSE EFFECTS OF NEW TREATMENT PROTOCOLS. Marcia Boehmke, RN, ANPc, DNS, University at Buffalo, Buffalo, NY.

The purpose of this pilot study was gain an understanding of current symptoms/symptom clusters women with early breast cancer experienced during adjuvant treatment through interpretation of narrative stories.

(1) What are the common experiences and shared meanings of early-stage breast cancer women’s symptoms during adjuvant chemotherapy? (2) Do these symptom experiences contribute to increased levels of symptom distress? (3) How do women interpret these symptoms? (4) How do they describe the symptom effect on their quality of life?

The study was guided by Hermeneutic Phenomenological methodology that questions the meaning of life experiences and explores how people interpret their lives and make meaning of what they experience.

A potential list of subjects who meet the inclusion criteria for the initial purposive sample was identified by an area breast surgeon. Women had to meet the following criteria: primary breast cancer diagnosis, treatment with adjuvant chemotherapy and have no other co-morbid condition.

Qualitative inquiry using the aforementioned phenomenological approach was used to collect, code, and analyze the data. This methodology utilizes purposive sampling of individuals who have the appropriate relevant experiences. This approach emphasizes the complexity of this human experience and the need to study this lived-experience holistically. In this study, interviews and/or focus groups will consist of women with primary, early-stage breast cancer undergoing adjunct chemotherapy. Variables to be studied include the symptom distress experience, identification of the most distressful symptom clusters, and self-care management strategies employed. Using this phenomenological method of inquiry, data analysis consisted of: bracketing, intuiting, analyzing, and describing the data.

Data analyses determined that women experienced severe bone, pelvic and joint pain and moderate numbness and tingling of their extremities after receiving Taxol, a drug recently added to breast cancer treatment protocols. These symptoms affected their functioning and impaired their ability to exercise, a current intervention used to manage fatigue. Changes in taste affected appetite and nausea experienced. Diminished attention span (less than 10 minutes/task) could adversely affect performance of interventions aimed at directing attention to improve cognition that require a timeframe of over one hour.