A stepped care stress management intervention on cancer-related traumatic stress symptoms among breast cancer patients—a randomized study in group vs. individual setting
Menée en Suède auprès de 425 patientes atteintes d'un cancer du sein récemment diagnostiqué, cette étude évalue l'efficacité, du point de vue de la réduction des symptômes de stress traumatique, d'une intervention dérivée des thérapies cognitives et mise en oeuvre de façon individuelle ou collective
Objective : To evaluate the mode of delivery of a stress management intervention, in a group or individual setting, on self-reported cancer-related traumatic stress symptoms. A secondary aim was to evaluate a stepped care approach. Methods : All study participants (n = 425), who were female, newly diagnosed with breast cancer and receiving standard oncological care were offered Step I of the stepped care approach, a stress management education (SME). Thereafter, they were screened for cancer-related traumatic stress symptoms, and, if present (n = 304), were invited to join Step II, a more intense intervention, derived from cognitive behavioral therapy, to which they were randomized to either a group (n = 77) or individual (n = 78) setting. To assess cancer-related traumatic stress symptoms, participants completed the Impact of Event Scale and the Hospital Anxiety and Depression Scale at the time of inclusion, three-months post-inclusion and approximately 12-months post-inclusion. Results : The SME did not significantly decrease any of the cancer-related traumatic stress symptoms. No statistically significant differences were found between the group and the individual setting interventions. However, only 54% of the participants attended the group setting compared to 91% for the individual setting. Conclusion : The mode of delivery had no effect on the cancer-related traumatic stress symptoms; however, the individual setting was preferred. In future studies, a preference-based RCT design will be recommended for evaluating the different treatment effects. Copyright © 2015 John Wiley & Sons, Ltd.