Testing the effects of treatment complications on a cognitive-behavioral intervention for reducing symptom severity.
Patients (n = 231) diagnosed with solid tumors and undergoing chemotherapy were randomly assigned to the experimental arm (n = 114) or to conventional care (n = 117). A symptom severity index based on summed severity scores across 15 symptoms was the primary outcome. Building on previously published work, an analysis was undertaken to determine the effects of patient characteristics and treatment complications on reductions in symptom severity achieved by a trial of a cognitive-behavioral intervention (CBI). The impact of the intervention on symptom severity differed by the occurrence of neutropenic events, chemotherapy dose delays or dose reductions, and number of comorbid conditions. Patients with more comorbid conditions, as well as those who did not experience neutropenia or dose delay/reduction, who received the intervention reported lower severity at 20 weeks compared to those who received conventional care. This research begins to specify the clinical conditions under which CBIs are effective in lowering symptom severity.
Sikorskii
Alla
A
College of Nursing, Michigan State University, East Lansing, Michigan 48824, USA.
Given
Charles
C
Given
Barbara
B
Jeon
Sangchoon
S
McCorkle
Ruth
R
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001521:Behavior Therapy / Q000706:statistics & numerical data*; D015928:Cognitive Behavioral Therapy / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D009503:Neutropenia / Q000453:epidemiology / Q000517:prevention & control; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000453:epidemiology* / Q000517:prevention & control*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D000970:Antineoplastic Agents