Psychoeducation for Spouses of Women with Breast Cancer

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DESCRIPTION (provided by applicant): In 2007, an estimated 178, 480 women were newly diagnosed with non-metastatic breast cancer and an additional 62,030 will be diagnosed with in situ [ductal or lobular] disease (ACS, 2007). Although breast cancer is a disease of the breast, it is an illness that impacts both the spouse and the diagnosed patient. Both cross sectional and longitudinal studies have documented the presence of substantial anxiety, depressed mood, tension in the marriage, and marital communication difficulties that are attributed to the cancer. Despite the magnitude of these issues and the large numbers affected, intervention research to help couples has lagged far behind descriptive research. Aims: The purpose of this study is to test the efficacy of a 5-session, fully manualized psychoeducational intervention, the Helping Her Heal Program, and its impact on the couple's adjustment to recently diagnosed non-metastatic breast cancer. The intervention derives from 2 theories, the Relational Model of Adjustment to Breast Cancer and Bandura's Social Cognitive Theory. Design/Methods: A total of 288 couples will be recruited from multiple provider sites in the Pacific Northwest and randomized into either the experimental or alternative treatment control group [standard care]. Spouses in the experimental group will receive 5, 1-hour face-to-face delivered educational sessions from a specially trained patient educator. At-home assignments will involve both the spouse and diagnosed wife. Spouses in the control group will receive a 1-time mailing of a brochure available in the public domain that focuses on supporting a diagnosed wife with breast cancer. Both wives and spouses will be measured at baseline, at immediate exit from the intervention, and at 3- and 6-months follow-up on standardized measures of adjustment (anxiety, depressed mood, behavioral management skills, self-confidence to manage, marital adjustment, marital communication, and spouses' support to the wife). Repeated measures ANCOVA will be used to evaluate intervention efficacy. PUBLIC HEALTH RELEVANCE: Despite the almost 200,000 women and their spouses who are affected annually by breast cancer, programs to assist them manage the impact of the cancer on their lives and marital adjustment have been sorely lacking. The proposed intervention offers a sustainable educational program with high potential for easy transfer to real life provider settings.