Congress Abstracts 2004

13

DECREASING SYMPTOM LIMITATIONS: EFFECTS OF A COGNITIVE BEHAVIORAL INTERVENTION. Ardith Doorenbos, PhD, RN, Barbara Given, PhD, RN, FAAN, and Charles Given, PhD, Michigan State University, East Lansing, MI; Ruth McCorkle, PhD, RN, FAAN, Yale University, New Haven, CT; and Bernadine Cimprich, PhD, RN, FAAN, University of Michigan, Ann Arbor, MI.

Symptom limitations have a significant negative influence on quality of life among patients with cancer. It is important for oncology nurses to gain an understanding of interventions that ameliorate the impact of symptom limitations.

This study seeks to determine if a cognitive behavioral intervention decreases the impact of symptom limitations among newly diagnosed cancer patients who are receiving chemotherapy.

The intervention was based on cognitive behavioral theory and focused on four problem-solving intervention strategies: Self-care management, providing information and decision-making, counseling and support, and communication with providers.

This randomized control trial of ten contacts over 20 weeks among 237 (118 experimental and 119 control group) patients with solid tumor cancers used an iterative, cognitive behavioral intervention by the nurse and patient working collaboratively to identify needs and adapting the intervention to the patients’ needs based on 15 common cancer symptoms in the experimental group. The control group continued to receive conventional care. Interviews occurred at baseline, 10 weeks, 20 weeks, and 32 weeks.

A two-level hierarchical linear modeling (HLM) was used. Level 1 is the equation for the trajectory of each individual, representing change over time within person or the repeated measures (i.e., the four interviews of a patient with cancer). Level 2 explains that trajectory via person-specific characteristics.

Findings include higher scores of symptom limitation in the control group compared to patients receiving the intervention at 10 weeks (p = .001), 20 weeks (p = .004), and 32 weeks (p = .055). At the onset of the study, younger patients reported more symptom limitations than their older counterparts, however, this trend was reversed by the end of the study. The results corroborate previous studies that report positive effects of cognitive behavioral interventions among patients with cancer. Findings also suggest that cognitive behavioral interventions focused on symptoms may help younger patients with cancer decrease symptom limitations, which may help to improve their quality of life.