Peer-counseling for women newly diagnosed with breast cancer: A randomized community/research collaboration trial

作者：Giese Davis Janine^*; Bliss I**erg Caroline; Wittenberg Lynne; White Jennifer; Star Path; Zhong Lihong; Cordova Matthew J; Houston Debra; Spiegel David

来源：Cancer, 2016, 122(15): 2408-2417.

DOI：10.1002/cncr.30036

• breast neoplasms
• counseling
• quality of life
• patient-navigation
• posttraumatic stress

BACKGROUNDWe conducted a randomized controlled trial of peer-counseling for newly diagnosed breast cancer (BC) patients as a community/research collaboration testing an intervention developed jointly by a community-based-organization serving women with cancer and university researchers.
METHODSWe recruited 104 women newly diagnosed with BC at any disease stage. Prior to randomization, all received a one-time visit with an oncology nurse who offered information and resources. Afterwards, we randomized half to receive a match with a Navigator with whom they could have contact for up to 6 months. We recruited, trained, and supervised 30 peer counselors who became Navigators. They were at least one-year post-diagnosis with BC. Controls received no further intervention. We tested the effect of intervention on breast-cancer-specific well-being and trauma symptoms as primary outcomes, and several secondary outcomes. In exploratory analyses, we tested whether responding to their diagnosis as a traumatic stressor moderated outcomes.
RESULTSWe found that, compared with the control group, receiving a peer-counseling intervention significantly improved breast-cancer-specific well-being (p=0.01, Cohen's d=0.41) and maintained marital adjustment (p=0.01, Cohen's d=0.45) more effectively. Experiencing the diagnosis as a traumatic stressor moderated outcomes: those with a peer counselor in the traumatic stressor group improved significantly more than controls on well-being, trauma and depression symptoms, and cancer self-efficacy.
CONCLUSIONSHaving a peer counselor trained and supervised to recognize and work with trauma symptoms can improve well-being and psychosocial morbidity during the first year following diagnosis of BC. Cancer 2016;122:2408-2417.

• 出版日期2016-8-1