Purpose/Objectives: To evaluate the FOCUS Program (family involvement, optimistic attitude, coping effectiveness, uncertainty reduction, and symptom management), a family-based program of care for women with recurrent breast cancer and their family caregivers.
Data Sources: Randomized clinical trial.
Setting: Midwest region of the United States.
Data Synthesis: The family-based program of care consisted of five components: family involvement, optimistic attitude, coping effectiveness, uncertainty reduction, and symptom management. The program was delivered in three home visits and two follow-up phone calls over a five-month period of time.
Conclusions: Patients with recurrent breast cancer and their family members reported high satisfaction with the FOCUS Program. Although the FOCUS Program had a number of strengths, limitations of the program also were identified that need to be addressed in future family-based interventions.
Implications for Nursing: A need exists for family-based programs of care that enable both patients and their family members to manage the multiple demands associated with recurrent breast cancer.
Badger, T.A., Braden, C., & Mishel, M.H. (2001). Depression burden, self-help interventions, and side effect experience in women receiving treatment for breast cancer. Oncology Nursing Forum, 28, 567-574.
Barg, F.K., Pasacreta, J.V., Nuamah, I., Robinson, K.D., Angelettia, K., Yasko, J., et al. (1998). A description of a psychoeducational intervention for family caregivers of patients with cancer. Journal of Family Nursing, 4, 394-413.
Bull, A.A., Meyerowitz, B.E., Hart, S., Mosconi, P., Apolone, G., & Liberati, A. (1999). Quality of life in women with recurrent breast cancer. Breast Cancer Research and Treatment, 54, 47-57.
Carver, C.S., Pozo, C., Harris, S.D., Noriega, V., Scheier, M.F., Robinson, D.S., et al. (1993). How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. Journal of Personality and Social Psychology, 65, 375-390.
Cella, D.F., Mahon, S.M., & Donovan, M.I. (1990). Cancer recurrence as a traumatic event. Behavioral Medicine, 16(1), 15-22.
Chekryn, J. (1984). Cancer recurrence: Personal meaning, communication, and marital adjustment. Cancer Nursing, 7, 491-498.
Classen, C., Butler, L.D., Koopman, C., Miller, E., DiMiceli, S., Giese-Davis, J., et al. (2001). Supportive-expressive group therapy and distress in patients with metastatic breast cancer: A randomized clinical intervention trial. Archives of General Psychiatry, 58, 494-501.
Donnelly, J.M., Kornblith, A.B., Fleishman, S., Zuckerman, E., Raptis, G., Hudis, C.A., et al. (2000). A pilot study of interpersonal psychotherapy by telephone with patients with cancer and their partners. Psycho-Oncology, 9, 44-56.
Ferrell, B.R., Dow, K.H., Leigh, S., Ly, J., & Gulasekaram, P. (1995). Quality of life in long-term cancer survivors. Oncology Nursing Forum, 22, 915-922.
Frost, M.H., Suman, V.J., Rummans, T.A., Dose, A.M., Taylor, M., Novotny, P., et al. (2000). Physical, psychological and social well-being of women with breast cancer: The influence of disease phase. Psycho-Oncology, 9, 221-231.
Ganz, P.A., Coscarelli, A., Fred, C., Kahn, B., Polinsky, M.L., & Petersen, L. (1996). Breast cancer survivors: Psychosocial concerns and quality of life. Breast Cancer Research and Treatment, 38, 183-199.
Giese-Davis, J., Hermanson, K., Koopman, C., Weibel, D., & Spiegel, D. (2000). Quality of couples' relationship and adjustment to metastatic breast cancer. Journal of Family Psychology, 14, 251-266.
Gotay, C. (1984). The experience of cancer during early and advanced stages: The views of patients and their mates. Social Science and Medicine, 18, 605-613.
Hack, T.F., & Degner, L.F. (1999). Coping with breast cancer: A cluster analytic approach. Breast Cancer Research and Treatment, 54, 185-194.
Harpham, W.S. (1997). When a parent has cancer: A guide to caring for your children. New York: HarperCollins.
Helgeson, V.S., Cohen, S., Schulz, R., & Yasko, J. (1999). Education and peer discussion group interventions and adjustment to breast cancer. Archives of General Psychiatry, 56, 340-347.
Jepson, C., McCorkle, R., Adler, D., Nuamah, I., & Lusk, E. (1999). Effects of home care on caregivers' psychosocial status. Image--The Journal of Nursing Scholarship, 31, 115-120.
Koopman, C., Hermanson, K., Diamond, S., Angell, K., & Spiegel, D. (1998). Social support, life stress, pain and emotional adjustment to advanced breast cancer. Psycho-Oncology, 7, 101-111.
Lazarus, R., & Folkman, S. (Eds.). (1984). Stress, appraisal, and coping. New York: Springer.
Lazarus, R.S. (2000). Evolution of a model of stress, coping, and discrete emotions. In V.H. Rice (Ed.), Handbook of stress, coping, and health (pp. 195-222). Thousand Oaks, CA: Sage.
Lewis, F.M., & Deal, L.W. (1995). Balancing our lives: A study of the married couple's experience with breast cancer recurrence. Oncology Nursing Forum, 22, 943-953.
Marcus, A.C., Garrett, K.M., Cella, D., Wenzel, L.B., Brady, M.J., Crane, L.A., et al. (1998). Telephone counseling of breast cancer patients after treatment: A description of a randomized clinical trial. Psycho-Oncology, 7, 470-482.
Maunsell, E., Brisson, J., Deschenes, L., & Frasure-Smith, N. (1996). Randomized trial of a psychologic distress screening program after breast cancer: Effects on quality of life. Journal of Clinical Oncology, 14, 2747-2755.
McCorkle, R., & Quint-Benoliel, J. (1983). Symptom distress, current concerns and mood disturbance after diagnosis of life-threatening disease. Social Science and Medicine, 17, 431-438.
McCubbin, M.A., & McCubbin, H.I. (1996). Resiliency in families: A conceptual model of family adjustment and adaptation in response to stress and crises. In H.I. McCubbin, A.I. Thompson, & M.A. McCubbin (Eds.), Family assessment: Resiliency, coping, and adaptation-- Inventories for research and practice (pp. 1-64). Madison, WI: University of Wisconsin.
McCue, K. (1994). How to help children through a parent's serious illness. New York: St. Martin's Griffin.
McEvoy, M.D., & McCorkle, R. (1990). Quality of life issues in patients with disseminated breast cancer. Cancer, 66(Suppl. 6), 1416-1421.
Mishel, M.H., Hostetter, T., King, B., & Graham, V. (1984). Predictors of psychosocial adjustment in patients newly diagnosed with gynecological cancer. Cancer Nursing, 7, 291-299.
Mood, D., & Bickes, J. (1989). Strategies to enhance self-care in radiation therapy [Abstract]. Oncology Nursing Forum, 16(Suppl.), 143.
Northouse, L.L., Dorris, G., & Charron-Moore, C. (1995). Factors affecting couples' adjustment to recurrent breast cancer. Social Science and Medicine, 41, 69-76.
Northouse, L.L., Laten, D., & Reddy, P. (1995). Adjustment of women and their husbands to recurrent breast cancer. Research in Nursing and Health, 18, 515-524.
Pasacreta, J.V., & McCorkle, R. (2000). Cancer care: Impact of interventions on caregiver outcomes. Annual Review of Nursing Research, 18, 127-148.
Silberfarb, P.M., Philibert, D., & Levine, P.M. (1980). Psychosocial aspects of neoplastic disease: II. Affective and cognitive effects of chemotherapy in patients with cancer. American Journal of Psychiatry, 137, 597-601.
Spencer, S.M., Lehman, J.M., Wynings, C., Arena, P., Carver, C.S., Antoni, M.H., et al. (1999). Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients. Health Psychology, 18, 159-168.
Spiegel, D., Bloom, J.R., Kraemer, H.C., & Gottheil, E. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 2, 888-891.
Toseland, R.W., Blanchard, C.G., & McCallion, P. (1995). A problem solving intervention for caregivers of patients with cancer. Social Science and Medicine, 40, 517-528.
Weisman, A.D., & Worden, J.W. (1985). The emotional impact of recurrent cancer. Journal of Psychosocial Oncology, 3(4), 5-16.
Weitzner, M.A., McMillan, S.C., & Jacobsen, P.B. (1999). Family caregiver quality of life: Differences between curative and palliative cancer treatment settings. Journal of Pain and Symptom Management, 17, 418-428.
Worden, J.W. (1989). The experience of recurrent cancer. CA: A Cancer Journal for Clinicians, 39, 305-310.