Arving, C., Sjödén, P. O., Bergh, J., Hellbom, M., Johansson, B., Glimelius, B. & Brandberg, Y. (2007). Individual psychosocial support for breast cancer patients: a randomized study of nurse versus psychologist interventions and standard care. Cancer Nursing, 30, E10–E19.

Patients were randomized to two intervention groups:  Individual Psychosocial Support, provided by a trained oncology nurse (INS), and Individual Psychosocial Support, provided by a psychologist (IPS). Both interventions used the same techniques of relaxation, distraction, activity scheduling, and ways to improve communication. The number of sessions and time intervals between sessions varied according to the needs and desires of individual patients. Each session lasted 45 to 60 minutes, in which patients' problems were identified and developments were made to help manage these problems. Patients were provided with written and oral instructions on how to practice these strategies. Quality of life questionnaires were administered at baseline and at one, three, and six months.

• The study included 179 women with breast cancer about to start adjuvant treatment.
• Mean age was 55 years (range 23–87).
• Of the participants, 136 were married/cohabitant, and the majority (n = 130) were in stage T1.
• Most participants had received no preoperative chemotherapy.
• For postoperative treatment, most had received local radiation therapy only (n = 100), hormonal therapy (n = 88), or adjuvant polychemotherapy (n = 69).
• Patients were excluded if they had ongoing psychiatric illness, previous cancer diagnosis, or inability to speak and understand Swedish.

Department of Oncology, Uppsala University Hospital

Patients were undergoing the active treatment phase of care.

This was a prospective, randomized study.

European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)

Intervention groups had lower fatigue scores on the EORTC-QLQ-C30 at baseline, one month, and six months; these differences were minimal and not statistically significant.

• Twenty percent of the patients did not complete all three assessments.
• A significantly higher proportion of patients randomized to the INS group were diagnosed in stage N0 compared to the other groups. It is unclear whether this had a significant impact on the results.