title: Breast cancer: education, counseling, and adjustment among patients and partners: a randomized clinical trial.
abstract: BACKGROUND
  Although various forms of psychoeducation and counseling interventions have been examined among patients with a variety of diagnoses, the unique contribution of phase-specific psychoeducation and telephone counseling (TC) to the ongoing process of adjustment has not been explored among patients with breast cancer and their partners.
  
  
  OBJECTIVE
  To conduct a randomized controlled clinical trial of phase-specific evidence-based psychoeducation and TC interventions to enhance emotional, physical, and social adjustments in patients with breast cancer and their partners.
  
  
  METHODS
  A purposive sample of 249 patient-partner dyads were assigned randomly to one of four groups: (a) control group receiving disease management (DM), (b) standardized psychoeducation (SE), (c) TC, or (d) standardized psychoeducation plus telephone counseling (SE + TC). Data were collected at baseline, diagnostic, postsurgery, adjuvant therapy, and ongoing recovery phases measuring emotional, physical, and social adjustments.
  
  
  RESULTS
  Patients showed poorer adjustment over time in the DM group relative to those receiving interventions on selected measures of emotional adjustment. All patients showed improvement over time in overall health and adjustment in social and vocational environments. Partners in all groups exhibited improvement over time for measures of adjustment in the social environment but no changes in psychological well-being or overall health. Partners in the TC group had poorer scores on physical symptoms compared with the SE + TC group and poorer vocational scores compared with the DM group.
  
  
  CONCLUSIONS
  Findings from this study provide preliminary support for the value of phase-specific SE and TC interventions to enhance selected adjustment outcomes for patients with breast cancer and their partners.
authors.affiliation: New York University Medical Center, USA. wendy.budin@nyu.edu
authors.forename: Wendy C
authors.initials: WC
authors.lastname: Budin
authors.forename: Carol Noll
authors.initials: CN
authors.lastname: Hoskins
authors.forename: Judith
authors.initials: J
authors.lastname: Haber
authors.forename: Deborah Witt
authors.initials: DW
authors.lastname: Sherman
authors.forename: Greg
authors.initials: G
authors.lastname: Maislin
authors.forename: Jacqueline R
authors.initials: JR
authors.lastname: Cater
authors.forename: Frances
authors.initials: F
authors.lastname: Cartwright-Alcarese
authors.forename: Mildred Ortu
authors.initials: MO
authors.lastname: Kowalski
authors.forename: Christina Beyer
authors.initials: CB
authors.lastname: McSherry
authors.forename: Renee
authors.initials: R
authors.lastname: Fuerbach
authors.forename: Shilpa
authors.initials: S
authors.lastname: Shukla
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000145:classification / Q000523:psychology* / Q000628:therapy; D003131:Combined Modality Therapy; D003376:Counseling; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D012917:Social Adjustment