Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer

Jin-Hee Park; Mison Chun; Yong Sik Jung; Sun Hyoung Bae; Young-Mi Jung

doi:10.4040/jkan.2018.48.6.669

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Park, Chun, Jung, Bae, and Jung: Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer

Original Article

J Korean Acad Nurs 2018;48(6):669-678.

Published online: 15 January 2018

DOI: https://doi.org/10.4040/jkan.2018.48.6.669

Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer

Jin-Hee Park¹, Mison Chun², Yong Sik Jung³, Sun Hyoung Bae¹, Young-Mi Jung^4,

¹College of Nursing · Research Institute of Nursing Science, Ajou University, Suwon

²Department of Radiation Oncology, School of Medicine, Ajou University, Suwon

³Department of Surgery, School of Medicine, Ajou University, Suwon

⁴Department of Nursing, College of Health Sciences, Cheongju University, Cheongju, Korea

Address reprint requests to : Jung, Young-Mi Department of Nursing, College of Health Sciences, Cheongju University, 298 Daeseong-ro, Cheongwon-gu, Cheongju 28503, Korea Tel: +82-43-229-7848 Fax: +82-43-229-8969 E-mail: j-dudal@hanmail.net

Received 27 June 2018 Revised 5 November 2018 Accepted 5 November 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer.

Methods

A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast.

Results

Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group.

Conclusion

These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

Keywords: Breast Neoplasms, Psychological Stress, Self-Management, Quality of Life, Psychosocial Support Systems

References

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Table 1.

Homogeneity Test of Demographic and Clinical Characteristics between Two Groups

Variables	Categories	Exp. (n=25)	Cont. (n=22)	χ²	p
Variables	Categories	n (%)	n (%)	χ²	p
Age (yr)	<40	5 (45.5)	6 (54.5)	1.51	.471
	40~49	13 (50.0)	13 (50.0)
	≥50	7 (70.0)	3 (30.0)
Educational level	≤High school	13 (46.4)	15 (53.6)	0.37	.204
	≥University	12 (63.2)	7 (36.8)
Marital status	Single	4 (50.0)	4 (50.0)	0.34	.573
	Married	21 (53.8)	18 (46.2)
Occupation	No	6 (35.3)	11 (64.7)	0.08	.061
	Yes	19 (63.3)	11 (36.7)
Cancer stage	I	13 (65.0)	7 (35.0)	2.62	.270
	II	10 (41.7)	14 (58.3)
	III	2 (66.7)	1 (33.3)
Method of surgery	Partial mastectomy	23 (51.1)	22 (48.9)	-	.278^†
	Total mastectomy	2 (100.0)	0 (0.0)
Chemotherapy	No	9 (75.0)	3 (25.0)	3.08	.077
	Yes	16 (45.7)	19 (54.3)
Hormonal therapy	No	4 (57.1)	3 (42.9)	-	.574^†
	Yes	21 (52.5)	19 (47.5)
Target therapy	No	23 (51.1)	22 (48.9)	-	.278^†
	Yes	2 (100.0)	0 (0.0)

Exp.=Experimental group; Cont.=Control group.

^† Fisher’s exact test.

Table 2.

Homogeneity Tests of Dependent Variables between Two Groups

Variable	Exp. (n=25)	Cont. (n=22)	t or z	p
Variable	M±SD	M±SD	t or z	p
Distress	5.40±3.03	4.63±2.26	-0.99	.329
Supportive care needs
Psychological needs	53.30±29.84	47.16±22.66	-0.78	.436^†
Health system and information needs	50.09±31.92	49.79±27.94	-0.14	.890^†
Physical and daily living needs	18.60±21.91	30.91±23.89	-1.96	.051^†
Patient care and supportive needs	27.00±17.91	31.36±28.54	-0.10	.923^†
Sexuality needs	14.67±17.39	15.01±24.52	-0.29	.773^†
Quality of life	96.85±15.15	96.51±14.77	-0.24	.814
Physical well-being Social/family well-being	23.60±3.25	21.96±4.72	-1.43	.159
Social/family well-being	17.89±5.54	17.23±5.96	-0.44	.662
Emotional well-being	14.52±5.84	17.24±3.35	-1.42	.155
Functional well-being	17.44±4.32	15.84±4.09	-1.59	.120
Breast cancer-specific subscale	23.36±4.51	24.28±4.07	0.01	.998

Exp.=Experimental group; Cont.=Control group; M=Mean; SD=standard deviation.

^† Mann-Whitney U test.

Table 3.

Comparison of Distress and Quality of Life between Two Groups

Variable	Group		Time				Difference		Difference		Cohen’s d
Variable	Group	T1	T2	T3	Source	F (p)	(T2-T1)		(T3-T1)		Exp.~Cont.
		M±SD	M±SD	M±SD			M±SD	t (p)	M±SD	t (p)	T2 T3	T3
Distress	Exp. (n=25)	5.40±3.03	2.52±1.69	1.88±1.54	Group	0.95 (.336)	-2.88±2.71	-2.94 (.005)	-3.52±3.64	-1.32 (.195)	0.84	0.37
					Time	28.06 (<.001)
	Cont. (n=22)	4.63±2.26	4.13±2.23	2.27±1.66	Group×Time	4.56 (.017)	-0.50±2.84		-2.36±2.30
Quality of life	Exp. (n=25)	96.85±16.14	99.79±8.90	102.11±7.74	Group	9.86 (.003)	2.94±17.60	2.69 (.010)	5.26±15.70	2.28 (.027)	0.77	0.66
					Time	2.30 (.125)
	Cont. (n=22)	95.70±12.15	86.92±9.49	91.95±11.41	Group×Time	5.74 (.011)	-8.79±11.10		-3.76±10.52
Physical well-being	Exp. (n=25)	23.60±3.25	21.32±2.81	22.04±3.02	Group	5.00 (.030)	-2.28±4.00	1.20 (.235)	-1.56±2.10	-0.33 (.740)	0.35	0.10
					Time	11.51 (<.001)
	Cont. (n=22)	22.27±4.17	18.31±3.78	21.18±4.94	Group×Time	1.49 (.230)	-3.95±5.49		-1.09±5.50
Social/family well-being	Exp. (n=25)	17.89±5.54	18.27±2.37	18.55±2.47	Group	2.81 (.101)	0.38±5.95	0.56 (.582)	0.66±6.15	1.12 (.269)	0.16	0.32
					Time	0.05 (.900)
	Cont. (n=22)	17.20±5.00	16.73±3.89	16.12±4.56	Group×Time	0.82 (.408)	-0.47±4.30		-1.08±4.13
Emotional well-being	Exp. (n=25)	14.52±5.84	18.32±2.90	19.60±2.16	Group	0.15 (.702)	3.80±7.11	2.47 (.019)	5.08±6.56	3.13 (.003)	0.68	0.87
					Time	7.67 (.003)
	Cont. (n=22)	17.18±2.97	17.09±3.02	17.45±2.44	Group×Time	6.65 (.003)	-0.09±3.16		0.27±3.73
Functional well-being	Exp. (n=25)	17.44±4.32	18.00±3.71	18.28±3.48	Group	4.68 (.036)	0.56±6.21	0.26 (.800)	0.84±5.84	-0.11 (.910)	0.07	0.03
					Time	1.05 (.340)
	Cont. (n=22)	15.77±2.79	15.95±3.98	16.77±3.89	Group×Time	0.09 (.860)	0.18±3.30		1.00±3.27
Breast cancer-specific subscale	Exp. (n=25)	23.36±4.51	23.24±4.32	23.28±4.39	Group	5.00 (.030)	-0.12±5.13	3.02 (.004)	-0.08±4.57	2.05 (.047)	0.87	0.59
					Time	6.81 (.004)
	Cont. (n=22)	23.36±3.30	19.05±4.46	20.55±4.50	Group×Time	6.09 (.006)	-4.32±4.29		-2.82±4.58

Exp.=Experimental group; Cont.=Control group; T1=Before intervention; T2=Immediately after intervention; T3=6 months after the end of intervention; M=Mean; SD=standard deviation.

Table 4.

Comparison of Supportive Care Needs between Two Groups

Variables	Group	Time				Difference		Difference (T3-T1)
		T1	T2	T3	χ² (p)	(T2-T1)		Difference (T3-T1)
		M±SD	M±SD	M±SD		M±SD	z^† (p)	M±SD	z^† (p)
Psychological needs	Exp. (n=25)	53.30±29.84	38.50±20.67	32.20±20.02	15.90 (<.001)	-14.80±33.20	-2.72	-21.10±27.76	-1.46
	Cont. (n=22)	47.16±22.66	58.07±16.61	37.73±21.90	8.81 (.012)	10.91±29.12	(.007)	-9.43±31.21	(.144)
Health system and information needs	Exp. (n=25)	50.09±31.92	28.91±14.44	26.82±19.06	8.83 (.013)	-21.18±35.27	-2.68	-23.27±31.67	-0.65
	Cont. (n=22)	49.79±27.94	61.47±19.14	36.67±26.16	9.39 (.009)	11.67±37.92	(.007)	-13.12±36.32	(.515)
Physical and daily living needs	Exp. (n=25)	18.60±21.91	29.00±19.03	17.20±17.44	6.61 (.037)	10.40±27.00	-1.21	-1.40±26.91	-0.24
	Cont. (n=22)	30.91±23.89	52.50±27.80	30.22±21.95	9.02 (.011)	21.59±34.38	(.227)	-0.68±23.11	(.814)
Patient care and supportive needs	Exp. (n=25)	27.00±17.91	21.60±19.24	15.20±13.27	5.58 (.058)	-5.40±30.55	-1.95	-11.80±23.80	-1.93
	Cont. (n=22)	31.36±28.54	43.41±26.33	30.91±26.89	6.79 (.034)	12.05±40.26	(.052)	-0.45±36.48	(.054)
Sexuality needs	Exp. (n=25)	14.67±17.39	19.33±23.78	15.00±19.39	0.27 (.873)	4.67±22.45	-3.28	0.33±24.71	-0.02
	Cont. (n=22)	15.01±24.52	48.86±25.76	14.02±22.48	19.92 (<.001)	32.95±30.59	(.001)	-1.89±28.86	(.982)

Exp.=Experimental group; Cont.=Control group; T1=Before intervention; T2=Immediately after intervention; T3=6 months after the end of intervention; M=Mean; SD=standard deviation.

^† Mann-Whitney U test.

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