Brief collaborative care intervention to reduce perceived unmet needs in highly distressed breast cancer patients: randomized controlled trial

Author:

Akechi Tatsuo12,Momino Kanae3,Katsuki Fujika4,Yamashita Hiroko5,Sugiura Hiroshi6,Yoshimoto Nobuyasu7,Wanifuchi-Endo Yumi8,Toyama Tatsuya8

Affiliation:

1. Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

2. Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan

3. Department of Nursing Administration and Management, Nagoya City University Graduate School of Nursing, Nagoya, Japan

4. Department of Psychiatric and Mental Health Nursing, Nagoya City University School of Nursing, Nagoya, Japan

5. Department of Breast Surgery, Division of Surgery, Hokkaido University Graduate School of Medicine, Hokkaido, Japan

6. Department of Breast and Endocrine Surgery, Nagoya City West Medical Center, Nagoya, Japan

7. Department of Breast and Endocrine Surgery, Kariya Toyota General Hospital, Kariya, Japan

8. Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

Abstract

Abstract Objectives Our newly developed brief collaborative care intervention program has been suggested to be effective in reducing breast cancer patients’ unmet needs and psychological distress; however, there has been no controlled trial to investigate its effectiveness. The purpose of this study was to examine the effectiveness of the program in relation to patients’ perceived needs and other relevant outcomes for patients including quality of life, psychological distress and fear of recurrence (Clinical trial register; UMIN-CTR, Clinical registration number; R5172). Methods Fifty-nine highly distressed breast cancer patients receiving adjuvant chemotherapy and/or hormonal therapy were randomly assigned either to a treatment as usual group or to a collaborative care intervention, consisting of four sessions that mainly included assessment of the patients’ perceived needs, learning skills of problem-solving treatment for coping with unmet needs and psycho-education provided by trained nurses supervised by a psycho-oncologist. Results Although >80% of the eligible patients agreed to participate, and >90% of participants completed the intervention, there were no significant differences with regard to patients’ needs, quality of life, psychological distress and fear of recurrence, both at 1 and 3 months after intervention. Conclusion Newly developed brief collaborative care intervention program was found to be feasible and acceptable. The trial, however, failed to show the effectiveness of the program on patients’ relevant subjective outcomes. Further intervention program having both brevity and sufficient intensity should be developed in future studies.

Funder

Japanese Ministry of Education, Culture, Science, and Technology

Japanese Ministry of Labor, Health, and Welfare

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Radiology Nuclear Medicine and imaging,Oncology,General Medicine

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