A randomized study of the effectiveness of a brief psychosocial intervention for women attending a gynecologic cancer clinic.
OBJECTIVE
While there are many psychosocial interventions for cancer patients, few are brief in nature. The aim of this study was to investigate the usefulness of a single-visit psychosocial intervention for gynecologic cancer patients.


METHODS
One hundred women attending a gynecologic cancer clinic as new patients were randomized to receive no intervention or a one-time meeting with a psychologist who discussed issues and concerns the woman might have about her cancer diagnosis. Thirty-eight of the women had a current or previous cancer. The women were given questionnaires measuring mood and quality of life at baseline, two weeks and three months after the intervention.


RESULTS
At baseline, 43 of the women in the control group completed questionnaires, as did 45 women randomized to the intervention. 21 of these women received the intervention. Women who received the intervention had greater decreases in anxiety, depression and overall distress over time. The control group also had decreases in anxiety and overall distress over time, but had an increase in depression. The women in the intervention group increased in physical, emotional, functional, and overall well being, while the control group only had a slight increase in overall well being over time. The difference between the groups in emotional well being at Time 2 approached significance (p=.08). The intervention group had increases in positive coping at Time 2, while the control group decreased (p's ranged from .02-.10). Three month follow-up data were available for 23 women in the control group and 15 in the intervention group. At Time 3 functional well being was significantly higher in the intervention group (p=.04). Information seeking and affect regulation remained higher in the intervention than the control group (p's=.002 and .02, respectively). When the women with cancer or previous cancer were examined, significant differences were seen for affect regulation at baseline (p=.0007), and anger two weeks later (p=.04), with the women in the control group being more angry. Utilization of other cancer resources was low with 12% of the women reporting that they used the Cancer Resource Center.


CONCLUSIONS
The results of this study show that there was a positive effect towards coping and quality of life for a one-time psychosocial intervention after the first visit to a gynecologic oncology practice. Women who were randomized to the intervention but did not go were more distressed at baseline than the women who did go. This suggests that incorporating psychosocial services as an integrated part of the new patient consultation may be very important to address patient's distress. Future studies with larger sample sizes may reveal more significant differences. Strategies to overcome the poor utilization of the cancer resource center are also clearly needed to improve awareness of these resources.
Powell
C Bethan
CB
Department of Obstetrics, Division of Gynecologic Oncology, Gynecology and Reproductive Sciences, UCSF, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA 94143, USA. bethan.powell@ucsfmedctr.org
Kneier
Andy
A
Chen
Lee-may
LM
Rubin
Mary
M
Kronewetter
Carol
C
Levine
Ellen
E
D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D001007:Anxiety / Q000209:etiology; D003221:Confusion / Q000209:etiology / Q000628:therapy; D003863:Depression / Q000209:etiology / Q000628:therapy; D005221:Fatigue / Q000209:etiology; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life