title: Outcomes of an uncertainty management intervention in younger African American and Caucasian breast cancer survivors.
abstract: OBJECTIVE
  To determine whether breast cancer survivors (BCSs) who received an uncertainty management intervention, compared to an attention control condition, would have less uncertainty, better uncertainty management, fewer breast cancer-specific concerns, and more positive psychological outcomes.
  
  
  METHODS
  A 2 × 2 randomized block, repeated-measures design, with data collected at baseline and two other points postintervention, as well as a few days before or after either a mammogram or oncologist visit.
  
  
  METHODS
  Rural and urban clinical and community settings.
  
  
  METHODS
  313 female BCSs aged 50 or younger; 117 African Americans and 196 Caucasians.
  
  
  METHODS
  Participants were blocked on ethnicity and randomly assigned to intervention or control. The intervention, consisting of a scripted CD and a guide booklet, was supplemented by four scripted, 20-minute weekly training calls conducted by nurse interventionists. The control group received the four scripted, 20-minute weekly training calls.
  
  
  METHODS
  Uncertainty in illness, uncertainty management, breast cancer-specific concerns, and positive psychological outcomes.
  
  
  RESULTS
  BCSs who received the intervention reported reductions in uncertainty and significant improvements in behavioral and cognitive coping strategies to manage uncertainty, self-efficacy, and sexual dysfunction.
  
  
  CONCLUSIONS
  The intervention was effective as delivered in managing uncertainties related to being a younger BCS.
  
  
  CONCLUSIONS
  The intervention can realistically be applied in practice because of its efficient and cost-effective nature requiring minimal direct caregiver involvement. The intervention allows survivors who are having a particular survival issue at any given point in time to access information, resources, and management strategies.
  
  
  CONCLUSIONS
  Materials tested in CD and guide booklet format could be translated into online format for survivors to access as issues arise during increasingly lengthy survivorship periods. Materials could be downloaded to a variety of electronic devices, fitting with the information needs and management styles of younger BCSs.
authors.affiliation: School of Nursing, University of North Carolina, Chapel Hill, NC, USA. germino@email.unc.edu
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Germino
authors.forename: Merle H
authors.initials: MH
authors.lastname: Mishel
authors.forename: Jamie
authors.initials: J
authors.lastname: Crandell
authors.forename: Laura
authors.initials: L
authors.lastname: Porter
authors.forename: Diane
authors.initials: D
authors.lastname: Blyler
authors.forename: Coretta
authors.initials: C
authors.lastname: Jenerette
authors.forename: Karen M
authors.initials: KM
authors.lastname: Gil
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001741:Black or African American / Q000208:ethnology / Q000523:psychology*; D000367:Age Factors; D001943:Breast Neoplasms / Q000208:ethnology / Q000451:nursing* / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008327:Mammography / Q000523:psychology; D008875:Middle Aged; D009859:Oncology Nursing / Q000379:methods; D010174:Pamphlets; D015397:Program Evaluation; D019035:Rural Health Services; D020377:Self Efficacy; D017741:Survivors / Q000523:psychology*; D035501:Uncertainty; D019037:Urban Health Services; D044465:White People / Q000208:ethnology / Q000523:psychology*