Krischer, M.M., Xu, P., Meade, C.D., & Jacobsen, P.B. (2007). Self-administered stress management training in patients undergoing radiotherapy. Journal of Clinical Oncology, 25, 4657–4662.

DOI Link

Intervention Characteristics/Basic Study Process

The intervention was a self-administered stress management training (SSMT) program for patients treated with radiation therapy. The usual care only (UCO) intervention included the usual psychosocial care typically provided at the institution where patients were receiving treatment. Participants in the SSMT program met individually with a nurse for approximately five minutes to receive instructional materials and explanations. The instructional materials consisted of a 15-minute prerecorded videotape, a 12-page booklet, and a 35-minute prerecorded audiotape titled “Active Relaxation,” which taught paced breathing, active relaxation, and positive thinking with guided imagery instructions. Data were collected at baseline and weeks 1, 2, and 3.

Sample Characteristics

  • The study reported on a sample of 310 patients prior to starting treatment with radiation.
  • The UCO group had 156 patients, and the SSMT group had 154 patients.

Setting

Multiple centers in South Florida

Study Design

A randomized controlled trial design was used.

Measurement Instruments/Methods

  • Mental Component Summary score of the Medical Outcomes Study–short form (SF-36)
  • Center for Epidemiologic Studies–Depression Scale (CES-D)
  • State-Trait Anxiety Inventory (STAI)–state anxiety
  • Statistical analyses repeated measures using SAS PROC MIXED based on unstructured covariance matrix model assumption
  • The models used for analysis included the baseline measures as covariates: the effects of treatment alone, time alone, the interaction of treatment with time, the quadratic effect of time, and the quadratic effect of treatment and time.

Conclusions

SSMT is effective only in those patients receiving radiotherapy with initially higher levels of psychological distress at baseline.

Limitations

Special training needs include the creation of the SSMT tool (instructional materials, video tables, and audiotapes).

Nursing Implications

Intervention requires screening for psychological distress.