Carpenter, J. S., Neal, J. G., Payne, J., Kimmick, G., & Storniolo, A. M. (2007). Cognitive-behavioral intervention for hot flashes. Oncology Nursing Forum, 34, E1–E8.

To pilot test the acceptability of a DVD platform to deliver a newly created cognitive-behavioral hot flash intervention and estimate its efficacy.

Participants viewed a DVD consisting of video clips demonstrating the intervention, which included one cognitive activity (distraction) and two behaviors (remain still, breathe). The video clips demonstrated the intervention during three situations:  resting at home, during housework, and in a work environment. Participants were asked to practice the intervention for one week. Outcomes measured were hot flash occurrence, severity, bother, mood disturbance, affect, hot flash disruption, and sleep disturbances.

• The sample was comprised of 49 women (26 at site 1 and 23 at site 2), with 40 completing all aspects of the study.
• Women with any stage of breast cancer or at high risk for disease were included.
• Mean age was 54.42 years, and all women were 21 years or older and experiencing hot flashes (93% were postmenopausal).
• Of the women, 75% were Caucasian.

The study was conducted at outpatient cancer clinics serving rural and urban areas in the midwestern and southeastern United States.

Patients were undergoing the long-term follow-up phase of care.

This was a nonrandomized, pre/post-test pilot study design.

• Center for Epidemiologic Studies Depression Scale (CESD)
• Profile of Mood States–Short Form (POMS-SF)
• Positive and Negative Affect Schedule (PANAS)
• Biolog®3991
• Hot flash severity and bother numeric rating scales
• Hot Flash-Related Daily Interference Scale (HFRDIS)
• Pittsburgh Sleep Quality Index (PSQI)
• Actiwatch®

The DVD was an accepted and feasible intervention delivery method. Although statistically significant improvement in hot flash parameters was observed, changes were equal to about a 10% change. The 10% reduction in hot flashes affected related outcomes, with the HFRDIS improving in all participants and CESD scores improving in the subset that reported the worst hot flash severity. No change in affect or sleep was noted.

• The unblinded, single-group design allows for placebo effect.
• The study had a small sample size.
• There was difficulty quantifying the frequency of intervention use; therefore, the variable was not included in the analyses.
• Drawbacks to using a DVD include the one-way nature of instruction and limited opportunity for participants to ask questions.