Dalton, J. A., Keefe, F. J., Carlson, J., & Youngblood, R. (2004). Tailoring cognitive-behavioral treatment for cancer pain. Pain Management Nursing, 5, 3–18.

DOI Link

Intervention Characteristics/Basic Study Process

Participants received standard cognitive-based therapy, profile-tailored cognitive-based therapy, or usual care. Those in both therapy groups received 5- to 50-minute sessions. Standard cognitive-based therapy includes comprehensive cognitive and behavioral therapy that evaluates thoughts, feelings, and behaviors. It uses six to eight treatment strategies to teach patients to understand the relationship between pain, suffering, and emotions; to use symptom coping skills, problem-solving, relaxation, and self control; and to modify cognitive distortions associated with emotional distress. Profile-tailored cognitive-behavioral therapy (CBT) matched patient scores on the Biobehavioral Pain Profile (BPP) to specific CBT modules:  environmental influences, loss of control, health care avoidance, past and current experience, physiological responsitivity, and thoughts of disease progression.

Sample Characteristics

  • In total, 131 participants were included.
  • Mean age was 52 years.
  • Of the participants, 72% were female, 63% were Caucasian, and 35% were African American.
  • Participants were experiencing cancer-related chronic pain for longer than 6 weeks, which was associated with disease progression, adjuvant therapy, or surgical exploration.
  • Participants had at least one elevated score on the BPP.
  • Most common diagnoses were breast, colon, and lung cancer and lymphoma.

Setting

One inpatient and three outpatient cancer centers in the Southeastern United States

Phase of Care and Clinical Applications

Participants were undergoing the active treatment phase of care.

Study Design

The study was a randomized trial.

Measurement Instruments/Methods

Profile of Mood States (POMS) Symptom Distress Scale

Results

No significant effects on fatigue were found.

Limitations

  • The study had poor retention. Only 28 patients completed the study; the end sample was very small.
  • No intention-to-treat analysis was performed.
  • Registered nurses received a two-day training course to deliver the intervention.
  • Space to provide the intervention.