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Couples Coping with
Cancer: Implementation
and Recruitment
Strategies
Gretchen Zunkel, PhD, CNS, RN
April 21, 2006
1
Purpose:
The long-term goal for this program of
research is to develop intervention strategies
for the patient-partner dyad following
diagnosis and treatment of early stage breast
cancer.
Goals
The short-term goals are to develop recruitment
strategies and determine the feasibility of
implementing Mindfulness-Based Stress Reduction
(MBSR) as an intervention program with outcomes
of enhanced stress related coping skills,
decreased depression, anxiety, and improved sleep
quality. A sub-goal is determine whether
relationship quality is improved.
Background for Research Project:
Couples Coping with Cancer
• Dis-synchronous illness trajectories- couples
may have different patterns of reaction and
response over the course of the illness
• Holding different explanatory models
• Differing views of responsive and supportive
behaviors
• Gender related communication issues
Patient and family are partners in the
health care process
• Impact of cancer diagnosis affects all
family members
• Stresses and uncertainties of illness can
be overwhelming
• For some families quality of life
deteriorates
• Other families become more resilient
Partners experience stress
• Family members report stressors of their
own during the illness experience
• Partners report mood disturbance, sleep
disorders, and work disruption
• Partners have reported feeling helpless
and isolated
• When their help is most needed, these life
crises may overwhelm significant others
Interpersonal interaction
• So much of what people do involves
interaction with others; interpersonal
functioning has the potential to be of great
importance in the stress-coping response.
• The tasks or issues are shaped by the
partner relationship and by what each
partner does as well as how the other
responds.
Communication issues
• Relationship talk
-improved adjustment for women
• Some supportive attempts are delivered
effectively and other fail to provide support
even though delivered with good intentions
• Unhelpful responses characterized by lack of
empathy or change of focus
• If perceived responsiveness is low, support
group was an alternative
•
(Pistrang & Barker, 1995)
Couple-Focused Intervention
• 6 sessions of a couple-focused group
intervention
• Lower depressive symptoms in active
group
• Women with unsupportive partners
benefited most
• Women with more physical impairment
benefited
(Manne et al., 2005)
Why Mindfulness-Based Stress Reduction?
•Individual intervention shown effective in both clinical
and non-clinical populations
•Potential for positive outcomes in both patient and partner
•Empirical evidence for decreased depression, anxiety,
improved sleep
•Process of engaging in intervention as a couple may
improve marital satisfaction and closeness
Implementation
• Discuss study with potential participant
• Send out information and measurement packet
• Retention and accrual
• Analyzing the data
Recruitment Strategies
•
•
•
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Recruitment strategies:
Building base for collaboration
Letters and flyers to clinicians
Post-cards and letters to be mailed to
patients
• Speaking at support groups
• Meet and greet oncologists who are in
direct role to encourage enrollment
Card Ad- mailing to potential
participants
Couples Coping with
Breast Cancer
Join an 8 week program for women with early stage breast
cancer and their male partners. Help University of
Minnesota School of Nursing researchers understand the
ways that couples respond to and manage a diagnosis of
breast cancer. Mindfulness-Based Stress Reduction is a
program that will teach you skills designed to reduce stress
in your life. The program consists of 8 2-1/2 hour sessions
and a one day retreat during which you will learn to practice
meditation with some light yoga. The group sessions will be
held on Friday afternoons.
For information, please contact Gretchen Zunkel, PhD, RN, CNS at
612-624-5435 or [email protected]
This program is sponsored by the University of Minnesota Center for Health
Trajectory Research
Brochure
Couples Coping with Breast
Cancer
You are invited to participate in a
research study to test a program
that will teach you a technique
called Mindfulness-Based Stress
Reduction developed by Jon
Kabat-Zinn. The skills in this
program are designed to provide
you with ways to reduce stress in
your life. The program consists of
8 2-1/2 hour sessions and a one
day retreat during which you will
learn to practice meditation with
some light yoga. Your participation
will help researchers to understand
the ways that couples respond to
and manage a diagnosis of breast
cancer.
What We Ask of You
Contact us at the phone
number listed
You will receive a phone
call to determine if you are
eligible for the study.
If you are eligible, you and
your partner will be invited
to participate in an 8 week
Mindfulness-Based Stress
Reduction program
Before and after the 8 week
program, and 3 months later,
you will each fill out a
packet of questionnaires
Who is Eligible
We are recruiting
couples: women with a
diagnosis of early stage
breast cancer (who are
within 9 months of
diagnosis) and their
male spouses/partners.
Both members must be
able to complete the
questionnaires in
English.
If you are unable to
participate in this study,
you can leave your
name and we will
contact you for future
studies. We need your
permission to keep your
name and address on
file.
Challenges:
• Obtaining consent from both members of
the couple
• Schedule intervention so both people can
participate
• Work around chemotherapy and radiation
• HIPPA is a barrier to communication with
clinicians about prospective subjects