POSTRADIATION COPING PROCESSES--A RANDOMIZED TRIAL

DESCRIPTION This randomized clinical trial tests two means of facilitating the adjustment of breast cancer (BC) patients (Stages I, II, and III) during an infrequently studied but critical timeframe, post-radiation therapy (RT). The majority of women diagnosed with BC receive RT but little nursing research is aimed at understanding and facilitating the coping processes following the common experience of RT. This project will provide the first critical comparison of two theoretically derived interventions which target the post-RT-coping processes of women with BC. The two interventions, which we have pilot tested, target the instrumental and emotional-coping functions specified by Leventhal's self-regulatory theory. First, Concrete Objective Information (COI) addresses unexpected experiences and side/effects/symptoms. Second, Expressed Emotional (EE) targets negative cancer-related thoughts and emotions which may be inhibited. The use of theoretically-based information, the COI improves patients' confidence, understanding, and ability to apply accurate expectations and interventions to specific side effects/symptoms and experiences associated with the end of RT and follow-up visits. The EE, by the linguistic integration of expressed emotion and the increased insight of the cancer experiences, reduced patients' active inhibition of cancer-related thoughts and emotions. Following baseline measures, one of the two interventions or a control condition will be administered during a patient's final week of RT at oncology centers in two different cities. Measures of outcome and mediating variables will be collected via the telephone at 1 week, 4 weeks, and 6 months post-RT. Repeated measures MANCOVA and hierarchial multiple regression analyses will be used to test the study hypotheses. The interventions tested in this study have high relevance to oncology nursing practice and will significantly advance theoretical understanding of coping processes.