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Oncology Nursing Forum 2009-May

An individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors: three pilot studies.

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Susan M Heidrich
Roger L Brown
Judith J Egan
Oscar A Perez
Cynthia H Phelan
Hyune Yeom
Sandra E Ward

Keywords

Abstract

OBJECTIVE

To test the feasibility and acceptability of an individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors and test the short-term effects of an IRIS on symptom distress.

METHODS

Two small randomized clinical trials and one pre-experimental study.

METHODS

Oncology clinic and community.

METHODS

41 women with breast cancer (aged 65 years and older) in pilot study 1, 20 in pilot study 2, and 21 in pilot study 3.

METHODS

In pilot study 1, women were randomized to the IRIS or usual care control. In pilot study 2, women were randomized to the IRIS or delayed IRIS (wait list) control. In pilot study 3, all women received the IRIS by telephone. Measures were collected at baseline, postintervention, and follow-up (up to four months).

METHODS

Feasibility, acceptability, symptom distress, symptom management behaviors, symptom management barriers, and quality of life.

RESULTS

Across three pilot studies, 76% of eligible women participated, 95% completed the study, 88% reported the study was helpful, and 91% were satisfied with the study. Some measures of symptom distress decreased significantly after the IRIS, but quality of life was stable. Women in the IRIS group changed their symptom management behaviors more than controls.

CONCLUSIONS

Preliminary evidence supports the need for and feasibility of an IRIS.

CONCLUSIONS

Nurses may help older breast cancer survivors manage their numerous chronic symptoms more effectively by assessing women's beliefs about their symptoms and their current symptom management strategies.

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