title: Reducing symptom limitations: a cognitive behavioral intervention randomized trial.
abstract: Until now, little research has been conducted examining the reactive dimension, or the degree to which a symptom limits an individual's life, in a multiplicity of symptoms. This research examines how problem-solving therapy organizes an intervention to decrease symptom limitations. The purpose was threefold: to determine if a cognitive behavioral intervention decreases the impact of symptom limitations among individuals newly diagnosed with cancer, who are receiving chemotherapy; to determine, after adjusting for covariates, how symptom limitations change over time; and to describe which symptoms are most limiting. This randomized control trial was conducted in two comprehensive and four community cancer centers. Two hundred thirty-seven individuals, aged 31-87, newly diagnosed with solid tumor cancers, participated. The experimental group (118 individuals) received a 10-contact, 18-week cognitive behavioral intervention focused on cancer- and chemotherapy-related symptoms. The control group (119 individuals) received conventional care. Interviews occurred at baseline, 10, 20, and 32 weeks. Data analysis used a two-level hierarchical linear model. Participants receiving the cognitive behavioral intervention had lower scores of symptom limitation than did participants in the control group. At the onset of the study, younger patients reported more symptom limitations than their older counterparts; however, this was reversed by the end of the study. The cognitive behavioral intervention was key to decreasing symptom limitations. Findings also suggest that nursing interventions may be particularly helpful to younger individuals in managing cancer-related symptom limitations.
authors.affiliation: College of Nursing, Michigan State University, East Lansing, MI 48824, USA. Ardith.doorenbos@hc.msu.edu
authors.forename: Ardith
authors.initials: A
authors.lastname: Doorenbos
authors.forename: Barbara
authors.initials: B
authors.lastname: Given
authors.forename: Charles
authors.initials: C
authors.lastname: Given
authors.forename: Natalya
authors.initials: N
authors.lastname: Verbitsky
authors.forename: Bernadine
authors.initials: B
authors.lastname: Cimprich
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000209:etiology / Q000451:nursing* / Q000523:psychology; D010353:Patient Education as Topic; D011340:Problem Solving; D011788:Quality of Life