Overall results showed that participants in the two treatment groups were more effective problem-solvers and experienced less psychological distress and improved quality of life. No differences between treatment groups were found. In this example, an individual psychotherapeutic intervention designed to increase a patient's problem-solving abilities was shown to result in a better quality of life and less psychological distress.
Self-administered stress management training for chemotherapy
In a randomized trial of 411 mixed-diagnosis cancer patients,[Level of evidence: I] traditional psychosocial care was compared with professionally administered and self-administered stress management for chemotherapy. The professional stress management consisted of a 60-minute individual educational session that included a review of common sources of chemotherapy-related stress and three specific stress-management techniques:
- Paced abdominal breathing.
- Progressive muscle relaxation with imagery.
- The use of coping self-statements.
The professional provided the patient with an audiotape of the individual session, prescribed daily practice of the three techniques, and met briefly with the patient before his or her first chemotherapy session.
In the self-administered group, a professional met with each patient for approximately 10 minutes, provided him or her with a packet of instructional materials about coping with chemotherapy, and briefly instructed the patient on their use. These materials included all of the same information provided in the professionally administered group plus the following:
- A 15-minute videotape.
- A 12-page booklet.
- A 35-minute relaxation audiotape.
Patients in this group were instructed to first view the videotape and then review the booklet, following its instructions for further training, practice, and use of the various techniques.
Results of this novel approach found that patients in the self-administered intervention reported significantly better physical functioning, vitality, and mental health and fewer role limitations than those reported by either of the other two groups. Patients in the professionally administered group reported no better outcomes than patients in the traditional-care group. Costs of the self-administered group were found to be significantly lower than those of the other two groups.
Mindfulness-based stress reduction for survivors of breast cancer
A randomized controlled trial of a 6-week mindfulness-based stress reduction intervention, compared with usual care, was conducted with 84 female survivors of breast cancer. All participants were within 18 months of completion of surgery, chemotherapy, and/or radiation therapy and were thus in the transitional period from completion of active treatment to posttreatment survivorship. The intervention consisted of weekly 2-hour group sessions conducted by a psychologist who followed a standardized protocol to teach participants sitting meditation, body scan, walking meditation, and gentle yoga. All participants received a training manual and four audiotapes to support home practice and were encouraged to practice daily.
Results included the following:
- The intervention group showed improvements in psychological measures (fear of recurrence, recurrence concerns, state-trait anxiety, and depression) and quality of life (physical functioning, role limitations, and energy).
- Those who practiced more frequently tended to show greater improvements.