title: An individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors: three pilot studies.
abstract: OBJECTIVE
  To test the feasibility and acceptability of an individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors and test the short-term effects of an IRIS on symptom distress.
  
  
  METHODS
  Two small randomized clinical trials and one pre-experimental study.
  
  
  METHODS
  Oncology clinic and community.
  
  
  METHODS
  41 women with breast cancer (aged 65 years and older) in pilot study 1, 20 in pilot study 2, and 21 in pilot study 3.
  
  
  METHODS
  In pilot study 1, women were randomized to the IRIS or usual care control. In pilot study 2, women were randomized to the IRIS or delayed IRIS (wait list) control. In pilot study 3, all women received the IRIS by telephone. Measures were collected at baseline, postintervention, and follow-up (up to four months).
  
  
  METHODS
  Feasibility, acceptability, symptom distress, symptom management behaviors, symptom management barriers, and quality of life.
  
  
  RESULTS
  Across three pilot studies, 76% of eligible women participated, 95% completed the study, 88% reported the study was helpful, and 91% were satisfied with the study. Some measures of symptom distress decreased significantly after the IRIS, but quality of life was stable. Women in the IRIS group changed their symptom management behaviors more than controls.
  
  
  CONCLUSIONS
  Preliminary evidence supports the need for and feasibility of an IRIS.
  
  
  CONCLUSIONS
  Nurses may help older breast cancer survivors manage their numerous chronic symptoms more effectively by assessing women's beliefs about their symptoms and their current symptom management strategies.
authors.affiliation: School of Nursing, University of Wisconsin-Madison, USA. smheidrich@wisc.edu
authors.forename: Susan M
authors.initials: SM
authors.lastname: Heidrich
authors.forename: Roger L
authors.initials: RL
authors.lastname: Brown
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Egan
authors.forename: Oscar A
authors.initials: OA
authors.lastname: Perez
authors.forename: Cynthia H
authors.initials: CH
authors.lastname: Phelan
authors.forename: Hyune
authors.initials: H
authors.lastname: Yeom
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Ward
mesh_terms: D000342:Affective Symptoms; D000368:Aged; D001007:Anxiety / Q000517:prevention & control; D001943:Breast Neoplasms / Q000451:nursing* / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009723:Nurse-Patient Relations; D009859:Oncology Nursing / Q000379:methods*; D010865:Pilot Projects; D011788:Quality of Life; D012720:Severity of Illness Index; D013689:Telephone