The Focus Program: Effects of a Family Intervention on the Quality of Life of Women with Recurrent Breast Cancer and Their Caregivers

2.50
Hdl Handle:
http://hdl.handle.net/10755/165668
Category:
Abstract
Type:
Presentation
Title:
The Focus Program: Effects of a Family Intervention on the Quality of Life of Women with Recurrent Breast Cancer and Their Caregivers
Author(s):
Northouse, Laurel
Author Details:
Laurel Northouse, PhD, Professor, University of Michigan, School of Nursing, Ann Arbor, Michigan, USA, email: lnortho@umich.edu
Abstract:
Recurrent breast cancer presents multiple demands on the emotional and physical well being of women with the disease and the family members who provide care for them. To date, few family-based intervention programs have been developed to address the problems reported by both women and their family caregivers. The purpose of this study was to determine if a family intervention, the FOCUS Program, could enhance the quality of life of women with recurrent breast cancer and their family caregivers following disease progression. A stress-coping theoretical framework, that included antecedent variables (current concerns, social support, family hardiness, symptom distress), mediating variables (appraisal, hopelessness, uncertainty, self-efficacy), and the outcome variable, quality of life guided this study. A longitudinal, randomized design was used in which women were stratified by number of recurrences and by type of treatment and then randomize to control (standard care) or experimental group (standard care plus the FOCUS Program). The sample consisted of 200 patient/family dyads who entered the study within one month following disease progression (accrual rate 60%). Approximately 20% of these seriously ill women died over the course of the study. The family intervention consists of three home visits with a masters-prepared nurse and two follow-up phone calls. Program content addressed family involvement, optimistic attitude, coping effectiveness, uncertainty reduction, and symptom management. A structured protocol manual and checklist was used to ensure consistent implementation of the intervention. Several instruments, with established reliability and validity were used to assess study variables. The mediating variables, also viewed as proximal outcomes in this study, were measured with the Appraisal of Illness/Caregiving Scale, Mishel Uncertainty Scale, Beck Hopelessness Scale, and Lewis Cancer Self-efficacy Scale. The distal outcome, quality of life was measured with the FACT- and SF-36 scales. Data was collected at baseline, prior to the intervention and at 3 and 6 months later. Descriptive statistics, regression analyses, and repeated measures MANOVA were used to analyze the data. Results indicated that women in the experimental group reported significantly less hopelessness, F (1,163) = 10.52, p=.001, and less negative appraisal of the illness, F(1,163) = 4.75, p =.03, at 3 months follow-up than control participants. Their family members reported significantly less negative appraisal of caregiving, F (1,163) = 9.5, p = .002, and better mental outcomes on the SF-36, F (1,163) = 4.1, p<.05, than did control family members. Even though participants expressed a high degree of satisfaction with the program, the significant effects of the program were not evident at the 6-month follow-up as women's disease continued to progress. In future studies, more sensitive outcome measures are needed and a mechanism for screening families at risk.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
26th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Diego, California, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleThe Focus Program: Effects of a Family Intervention on the Quality of Life of Women with Recurrent Breast Cancer and Their Caregiversen_GB
dc.contributor.authorNorthouse, Laurelen_US
dc.author.detailsLaurel Northouse, PhD, Professor, University of Michigan, School of Nursing, Ann Arbor, Michigan, USA, email: lnortho@umich.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/165668-
dc.description.abstractRecurrent breast cancer presents multiple demands on the emotional and physical well being of women with the disease and the family members who provide care for them. To date, few family-based intervention programs have been developed to address the problems reported by both women and their family caregivers. The purpose of this study was to determine if a family intervention, the FOCUS Program, could enhance the quality of life of women with recurrent breast cancer and their family caregivers following disease progression. A stress-coping theoretical framework, that included antecedent variables (current concerns, social support, family hardiness, symptom distress), mediating variables (appraisal, hopelessness, uncertainty, self-efficacy), and the outcome variable, quality of life guided this study. A longitudinal, randomized design was used in which women were stratified by number of recurrences and by type of treatment and then randomize to control (standard care) or experimental group (standard care plus the FOCUS Program). The sample consisted of 200 patient/family dyads who entered the study within one month following disease progression (accrual rate 60%). Approximately 20% of these seriously ill women died over the course of the study. The family intervention consists of three home visits with a masters-prepared nurse and two follow-up phone calls. Program content addressed family involvement, optimistic attitude, coping effectiveness, uncertainty reduction, and symptom management. A structured protocol manual and checklist was used to ensure consistent implementation of the intervention. Several instruments, with established reliability and validity were used to assess study variables. The mediating variables, also viewed as proximal outcomes in this study, were measured with the Appraisal of Illness/Caregiving Scale, Mishel Uncertainty Scale, Beck Hopelessness Scale, and Lewis Cancer Self-efficacy Scale. The distal outcome, quality of life was measured with the FACT- and SF-36 scales. Data was collected at baseline, prior to the intervention and at 3 and 6 months later. Descriptive statistics, regression analyses, and repeated measures MANOVA were used to analyze the data. Results indicated that women in the experimental group reported significantly less hopelessness, F (1,163) = 10.52, p=.001, and less negative appraisal of the illness, F(1,163) = 4.75, p =.03, at 3 months follow-up than control participants. Their family members reported significantly less negative appraisal of caregiving, F (1,163) = 9.5, p = .002, and better mental outcomes on the SF-36, F (1,163) = 4.1, p&lt;.05, than did control family members. Even though participants expressed a high degree of satisfaction with the program, the significant effects of the program were not evident at the 6-month follow-up as women's disease continued to progress. In future studies, more sensitive outcome measures are needed and a mechanism for screening families at risk.en_GB
dc.date.available2011-10-27T12:22:48Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:22:48Z-
dc.conference.date2001en_US
dc.conference.name26th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Diego, California, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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