Enhancing physical well-being and overall quality of life among underserved Latina-American cervical cancer survivors: feasibility study
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Evidence for the effectiveness of behavioral interventions are lacking for cervical cancer survivors (CCS). Disparities in survivorship outcomes exist for CCS, especially Latina-Americans. This study assessed the feasibility of implementing a culturally sensitive intervention delivered in a telephonic format.
A convenience sample of 23 Latina-Americans diagnosed with stages 1–3 invasive cervical cancer who were 1–3 years post diagnosis and disease free participated. A random assignment, pre- and post-test design was used with 15 intervention and 8 control participants. Intervention group participants completed 6 sessions that included problem-focused, telephone counseling. The areas covered included family and partner concerns and communication; relaxation and stress management; psychological, medical and treatment concerns; and self-nurturing activities. Outcomes were measured by the FACT-G QOL scale.
Increases in physical well-being and overall QOL were observed for the intervention group only (p < 0.05). The intervention group showed a non significant trend towards improvements in family/social, emotional and functional well-being from pre- to post-test.
Results demonstrate the feasibility of implementing a culturally responsive, telephonic behavioral intervention. The intervention was associated with an improvement in physical and overall quality of life. A randomized controlled trial with a long term follow-up is warranted.
Implications for Cancer Survivors
An ethnically sensitive, behaviorally based telephone counseling approach with Latina Americans cervical cancer survivors can achieve short term improvements in physical well-being and overall QOL.
KeywordsCervical cancer HRQOL Ethnic minority Behavioral intervention
- 1.Ries LAG, et al. SEER Cancer statistics review, 1975–2001. 2004 [cited 2006 December 28, 2006]; Available from: http://seer.cancer.gov/csr/1975_2001.
- 2.Krieger N, Quesenberry C, Peng T, Horn-Ross P, Stewart S, Brown S, et al. Social class, race/ethnicity, and incidence of breast, cervix, colon, lung, and prostate cancer among Asian, Black, Hispanic and White residents of the San Francisco Bay Area, 1988–92 (United States). 10, 6;1999.Google Scholar
- 4.Institute of Medicine. The unequal burden of cancer: an assessment of NIH research and programs for ethnic minorities and the medically underserved. Washington, DC: National Academy Press; 1999.Google Scholar
- 9.Napoles-Springer A, Stewart AL. Use of health-related quality of life measures in older and ethnically diverse U.S. populations. J Ment Health Aging. 2001;7:173–9.Google Scholar
- 11.Meyerowitz B, Formenti S, Ell K, Leedham B. Depression among Latina cervical cancer patients. J Soc Clin Psychol 2000;19:352–71.Google Scholar
- 14.Rehse B, Pukrop R. Effects of psychosocial interventions on quality of life in adult cancer patients: metaanalysis of 37 published controlled outcome studies. Patient Educ Couns 2002;50:179–86.Google Scholar
- 15.Sheard T, Maguire P. The effect of psychological interventions on anxiety and depression in cancer patients: results of two meta analysis. Br J Cancer 1999;80:170–80.Google Scholar
- 27.Whelan T, et al. The supportive care needs of newly diagnosed cancer patients attending a regional cancer center. Cancer 1997;80:1518–24. doi:10.1002/(SICI)1097-0142(19971015)80:8<1518::AID-CNCR21>3.0.CO;2-7.PubMedCrossRefGoogle Scholar
- 28.Lutgendorf S, et al. Quality of life and mood in women receiving extensive chemotherapy for gynecologic cancer. Cancer 2000;89:1402–11. doi:10.1002/1097-0142(20000915)89:6<1402::AID-CNCR26>3.0.CO;2-H.PubMedCrossRefGoogle Scholar
- 29.Auchincloss S. After treatment. Psychosocial issues in gynecologic cancer survivorship. Cancer 1995;76:2117–24. doi:10.1002/1097-0142(19951115)76:10+<2117::AID-CNCR2820761335>3.0.CO;2-7.PubMedCrossRefGoogle Scholar
- 34.Schover L, Fife M, Gershenson D. Sexual dysfunction and treatment for early stage cervical cancer. Cancer 1989;63:204–12. doi:10.1002/1097-0142(19890101)63:1<204::AID-CNCR2820630133>3.0.CO;2-U.PubMedCrossRefGoogle Scholar
- 35.Anderson B. Sexual functioning morbidity among cancer survivors. Current status and future research directions. Cancer 1985;55:1835–42. doi:10.1002/1097-0142(19850415)55:8<1835::AID-CNCR2820550832>3.0.CO;2-K.CrossRefGoogle Scholar
- 36.Anderson B. Predicting sexual and psychologic morbidity and improving the quality of life for women with gynecologic cancer. Cancer 1993;71:1678–90.Google Scholar
- 37.Lamb M. Effects of cancer on the sexuality and fertility of women. Seminars in Oncology Nursing. 1995;120–7. doi:10.1016/S0749-2081(05)80019-1.
- 39.Anderson B. Surviving cancer. Cancer 1994;74:1484–95. doi:10.1002/1097-0142(19940815)74:4+<1484::AID-CNCR2820741614>3.0.CO;2-9.CrossRefGoogle Scholar
- 43.Steginga SK, Dunn J. Women’s experiences following treatment for gynecological cancer. Oncol Nurs Forum 1997;28:1403–8.Google Scholar
- 49.Lev E, Owen S. Counseling women with breast cancer using principles developed by Alvert Bandura. Perspect Psychiatr Care 2000;36:2000.Google Scholar
- 52.Lev E, Daley K, Conner N, Reith M, Fernandez C, Owen S. An intervention to increase quality of life and self-care self-efficacy and decrease symptoms in breast cancer patients. Sch Inquiry Nurs Pract 2001;15:277–94.Google Scholar
- 53.Taylor KL, Lamdan RM, Siegel JE, Shelby R, Moran-Klimi K, Hrywna M. Psychological adjustment among African American breast cancer patients: one year follow-up results of a randomized psychoeducational group intervention. Health Psychol 2003;22:316–23. doi:10.1037/0278-6188.8.131.526.PubMedCrossRefGoogle Scholar
- 54.Antoni M, Lehman J, Kilbourn K, Boyers A, Culver J, Alferi S, et al. Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychol 2001;20:20–32. doi:10.1037/0278-6184.108.40.206.PubMedCrossRefGoogle Scholar
- 55.Edmonds C, Lockwood G, Cunningham A. Psychological response to long-term group therapy: a randomized trial with metastatic breast cancer patients. Psycho-Oncol 1999;8:74–91. doi:10.1002/(SICI)1099-1611(199901/02)8:1<74::AID-PON339>3.0.CO;2-K.CrossRefGoogle Scholar
- 58.Burish T. Behavioral and psychosocial cancer research. Building on the past, preparing for the future. Cancer 1991;67:865–7. doi:10.1002/1097-0142(19910201)67:3+<865::AID-CNCR2820671420>3.0.CO;2-N.PubMedCrossRefGoogle Scholar
- 59.National Cancer Institute. Surveillance, epidemiology and end results program. 2001 [cited 2001; Available from: http://www.seer.ims.nci.gov.
- 60.Shingleton H, Orr J. Cancer of the cervix. Philadelphia, PA: JB Lippincott Co; 1995.Google Scholar
- 61.Donnelly J, Kornblith A, Fleishman S. A pilot study of interpersonal psychotherapy by telephone with cancer patients and their partners. Psycho-Oncol 2000;9:44–56. doi:10.1002/(SICI)1099-1611(200001/02)9:1<44::AID-PON431>3.0.CO;2-V.CrossRefGoogle Scholar
- 63.Marcus AC, Garrett KM, Cella D. Telephone counseling of breast cancer patients after treatment: a description of a randomized clinical trial. Psycho-Oncol 1998;7:470–82. doi:10.1002/(SICI)1099-1611(199811/12)7:6<470::AID-PON325>3.0.CO;2-Z.CrossRefGoogle Scholar
- 67.Sandgren AK, McCaul KD. Short-term effects of telephone therapy for breast cancer patients. Health. Psychology (Savannah, Ga.) 2003;22:310–5.Google Scholar
- 74.Wenzel L, Robinson R, Blake D. the effects of problem-focused group counseling early stage gynecologic cancer. J Ment Health Couns 1995;17:81–93.Google Scholar
- 75.Office of Minority Health. Office of Minority Health publishes final standards for cultural and linguistic competence. In: editors. Closing the gap (pp.). Washington, DC: Office of Minority Health, DHHS; 2001.Google Scholar
- 76.Wenzel L, Dogan-Ates A, Habbal R. Reproductive concerns and quality of life in female cancer survivors. J Natl Cancer Inst Monographs. 2005 94–8. doi:10.1093/jncimonographs/lgi017.
- 77.American Cancer Society. Cancer facts and figures 2008. Atlanta, GA: American Cancer Society; 2007.Google Scholar