Congress Abstracts 2005

35

A TARGETED BREAST CANCER EDUCATION INTERVENTION (BCEI) FOR BREAST CANCER SURVIVORS: AN INTERIM ANALYSIS. Karen Hassey Dow, PhD, RN, FAAN, and Victoria Loerzel, RN, MSN, OCN^®, University of Central Florida, Orlando, FL; Ying Zhang, PhD, University of Iowa, Iowa City, IA; and Patrick McNees, PhD, Applied Health Science Inc., Orlando, FL.

Targeted psychoeducational interventions are known to maintain or improve quality of life during treatment for cancer.

This research study seeks to determine whether targeted psychoeducational interventions are effective in maintaining or improving quality of life in breast cancer survivors within the first year after treatment, a time considered high risk for poor quality of life.

The intervention is based on a multidimensional quality of life framework targeting high incidence symptoms for psychoeducational intervention: physical (pain, lymphedema, fatigue, menopausal symptoms), psychological (anxiety, depression, fear of recurrence), social (sexuality) and spiritual (meaning in illness).

This randomized clinical trial tests the impact of targeted psychoeducational interventions, collectively called the Breast Cancer Education Intervention (BCEI), among 250 breast cancer survivors. For the Intervention Group, the BCEI consists of three weekly psychoeducational intervention visits with an Advanced Practice Nurse (APN) followed by monthly follow-up for six months. The Wait Control (WC) Group receives usual care with monthly attention control and the BCEI delivered at the end of six months. This paper reports on the first 100 subjects with completed data. QOL assessment occurred at baseline, 3 months, and 6 months.

Generalized estimating equations (GEE) model based on Liang and Zeger (1986) was selected for longitudinal data analysis because this statistical model accounts for intra-subject correlations among repeated measurement of the same subject over time. Baseline demographics shows no significant differences between the two groups with exception that intervention subjects were married or living with partner (p < 0.05). QOL scores were calculated at baseline, three months, and six months.

Preliminary findings show that the BCEI was effective in improving QOL in the Intervention Group at three months compared with the WC Group. WC reported marked increase in fatigue, pain, and anxiety at three months. In addition, BCEI intervention effects on overall Physical QOL were retained from baseline to the end of six months. Findings suggest that breast cancer survivors benefit from targeted psychoeducational intervention rather than general symptom information within the first year after treatment. Implications for restructuring general symptom management to targeted interventions are indicated.