SELF-HELP INTERVENTION PROJECT - WOMEN RECEIVING BREAST-CANCER-TREATMENT

PURPOSE: The purpose of this study was to determine the efficacy of se lf-care/self-help promotion and uncertainty management interventions o ffered by the Self-Help Intervention Project (SHIP) for women receivin g chemotherapy, radiation therapy, or hormone therapy for breast cance r. DESCRIPTION OF STUDY: One hundred ninety-three women were randomly assigned either to one of three intervention groups (self-help course, uncertainty management, or self-help course plus uncertainty manageme nt) or to a control group. Data were analyzed by a repeated measures m ultivariate analysis of variance procedure using a two-level blocking factor (high and low resourcefulness) and four outcome variables (self -care, self-help, psychological adjustment, and confidence in cancer k nowledge). Data were collected at baseline (T-1), which was after init iation of adjuvant therapy, allowing for the emergence of treatment-re lated side effects; 6 to 8 weeks after T-1 (T-2); and 3 months after T -2 (T-3). RESULTS: At baseline, women having high resourcefulness comp ared with women having low resourcefulness evidenced greater self-care , self-help, psychological adjustment, and confidence in cancer knowle dge. Participation in SHIP interventions resulted in higher levels of self-care, self-help, psychological adjustment, and confidence in canc er knowledge by time effect in a significant number of women regardles s of their baseline resourcefulness. Women participating in SHIP inter ventions who had low baseline resourcefulness demonstrated the greates t change over time in the outcome variables. Post hoc results indicate d that the effect primarily was as tile result of changes in psycholog ical adjustment, confidence in cancer knowledge, and self-care. CLINIC AL IMPLICATIONS: The findings of this study address both the treatment effect for supportive care interventions and the needs that have emer ged from review of the last 20 years of supportive care research. Some SHIP interventions evidenced more strength than others; data indicate d that large percentages of women with low resourcefulness who receive d no SHIP interventions experienced a decrement in self-care, self-hel p, confidence in cancer knowledge, and psychological adjustment over t he time that they received adjuvant therapy. Women's level of confiden ce in their knowledge about cancer being sufficient for self-managemen t and self-help activities was not linked to baseline resourcefulness level. Thus, inherent resourcefulness was not a factor in need for sup portive services that could maintain or increase confidence in cancer knowledge usefulness for self-management and self-help. Healthcare pro viders should note that although the women with low resourcefulness be nefited the most from the interventions, women who evidenced high reso urcefulness at baseline reported the same level of need for confidence in cancer knowledge and for self-help.