An early structured psychoeducational intervention in patients with breast cancer: results from a feasibility study

Abstract

Background: Although the incidence of breast cancer in Italy is high, like in most Western countries, the role of psychosocial support in disease management and outcome is incompletely understood. A structured psychoeducational group intervention has been shown by Fawzy (J Psychosom Res. 1999, 45:191-200) to increase psychological well-being and natural killer immunological reactivity in patients with melanoma, with decreased relapse rate and prolonged survival time.

Objective: The aims of the present study were to assess the feasibility of Fawzy's intervention by preliminary evaluation of its usefulness on a sample of women with early-stage breast cancer.

Methods: Psychological reaction to the disease and its possible modification by the psychoeducational treatment were determined with the Mini-Mental Adjustment to Cancer scale at the time of study recruitment and at the end of the intervention.

Results: A total of 29 patients participated in the study. Rate of participation and adherence to the intervention were 83% and 100%, respectively. A significant reduction in anxious preoccupation was observed in treated patients, whereas the other coping strategies identified by the Mini-Mental Adjustment to Cancer scale were not significantly modified.

Conclusion: The results support the feasibility of the intervention. In particular, the reduction in anxious preoccupation, characterizing the early phase of adaptation to breast cancer, may be the target for psychosocial intervention including specific nursing contributions.

Implications for practice: The results obtained encourage investigating in more depth and with adequate methodology the role of psychoeducational group support for patients with early-stage breast cancer. In particular, they suggest that more attention should be given to the early phase, which follows the communication of cancer diagnosis and precedes the beginning of chemotherapy, which seems to be characterized by anxious preoccupation. A further indication resulting from the study and development of psychoeducational groups for patients with cancer is the opportunity to include cancer nursing among the topics that are addressed during psychoeducational group meetings because it seems to have been neglected in the available studies despite its evident relevance in cancer care.