Hospitalized, post-mastectomy coping modification and anxiety reduction

Abstract

The efficacy of a time-limited, psychotherapeutic treatment intervention aimed at modifying coping strategies and reducing anxiety in a population of hospitalized, post-mastectomy patients was studied. The study contained a two-part hypothesis. Part one stated that those post-mastectomy patients who received time-limited psychotherapy would demonstrate a greater reduction in state-anxiety than those post-mastectomy patients not receiving the psychotherapy. The second part of the hypothesis stated that, compared to the control group, patients receiving the intervention, would show an increase in problem-focused ways of coping and a concomitant decrease in emotion-focused ways of coping.;Impetus for the study came from several sources: (1) significant evidence of psychological morbidity associated with common breast cancer treatment; (2) documentation of stressful effects of hospitalization; (3) absence in the literature of investigations of the post-mastectomy period prior to hospital release and; (4) studies reporting effective use of psychological techniques in general medical, cancer, and breast cancer patients.;Thirty-six inpatient, post-mastectomy patients were recruited from the Adult Surgical Oncology Unit of a large metropolitan teaching hospital. After meeting inclusion criteria, patients were randomly assigned to either treatment or control groups.;All subjects were interviewed and administered the WCQ-R and STAI the day following surgery. Only those in the treatment group received four 45-minute psychotherapy sessions on four consecutive days. Both groups were readministered the instruments on their fifth day of hospitalization, usually prior to release.;General format for the psychotherapy sessions was primarily drawn from time-limited dynamic psychotherapy and crisis intervention literature, and included supportive and psychoeducational elements.;A repeated measures MANOVA comparing pretest and posttest scores, and a repeated measures ANOVA comparing pretest and posttest STAI scores failed to indicate a significant Group X Time interaction.;Possible reasons for lack of significant treatment effect, and practical and clinical implications are discussed.