THE IMPACT OF A NURSING INTERVENTION OF RELAXATION WITH GUIDED IMAGERY ON BREAST CANCER PATIENTS' STRESS AND HEALTH AS EXPANDED CONSCIOUSNESS.
Contributors: University of Texas at Austin.
Published: 1995
Number of pages: 302
Subjects: Health Sciences, Nursing.; Psychology, Clinical.
Description: This clinical study tested the effects of a nursing intervention employing relaxation with guided imagery on stress and on health experienced by women receiving combination chemotherapy treatment for breast cancer. It was supported by a theoretical framework synthesized from Margaret Newman's conceptualization of health as expanding consciousness and from psychophysiologic stress theory related to cancer.

A prospective, experimental, repeated measures design was used to investigate the differences over time in stress levels, changes in health, and chemotherapy related side effects for two groups of women undergoing chemotherapy, those receiving a nursing intervention employing relaxation with guided imagery and cancer care instruction (RGI+CCI) versus those women receiving cancer care instruction (CCI) only. Women who were randomized to the experimental condition of RGI+CCI were also assessed for characteristics that promoted or inhibited the use of relaxation with guided imagery as a nursing intervention. RGI was by audio tape, authored and recorded by the investigator. CCI was from nursing protocols developed for this study. Measures for stress included Cohen's Perceived Stress Scale (PSS10), Profile of Mood States (POMS), and the Stanford Inventory of Cancer Patient Adjustment. Qualitative data about health were collected through use of the Cantril Self-anchoring Striving Scale interview technique.

Subjects were 30 women predominately from rural Appalachia who were 3 to 8 weeks post modified radical mastectomy, lumpectomy, or segmental resection for Stage I or Stage II breast cancer and who were naive to chemotherapy. Baseline measurement and initial RGI treatment session were completed prior to the start of day 1, cycle 1 of chemotherapy. CCI was given as needed in face-to-face and telephone contacts. Subjects were followed for eight consecutive weeks counting from the first dose of chemotherapy; midpoint and endpoint measurement was done in the fifth and ninth weeks, respectively. Data on chemotherapy related side effects were self reported weekly during telephone interview. RGI tape use was reported weekly via postcards designed for that purpose.

Repeated measures ANOVA revealed significant treatment effects for one stress subscale: Coping with medical procedures. Incidence and severity of side effects were not significantly different between groups. Experimental subjects perceived RGI to be of benefit as a coping help. The caring presence of the investigator conveyed through the methodology of the study was perceived by both groups to be a coping help. Content analysis of interviews revealed all subjects evidenced changes in health as expanding consciousness over the course of the study. These were most likely a result of living with cancer as there was no compelling evidence that RGI acted to produce the changes seen. Implications for further research in this area and for clinical practice are discussed. RGI by audio tape proved to be a simple nursing intervention easily used with this patient population. The findings offer limited support for the premise that the intervention reduced patients' stress.
Notes: Source: Dissertation Abstracts International, Volume: 56-10, Section: B, page: 5416.

Thesis (PH.D.)--THE UNIVERSITY OF TEXAS AT AUSTIN, 1995.

School code: 0227.