Objective: To describe the role of telephone interpersonal counseling intervention (TIP-C) for reducing health disparities among rural women.
Purpose/Specific Aims: The purpose of this study was to pilot test the effectiveness of a telephone-delivered interpersonal counseling (TIP-C) intervention on symptom management and quality of life for rural women with breast cancer. The general aims of the study were to examine the effectiveness of TIP-C on rural women's management of depressive symptoms and fatigue and subsequently, their quality of life.
Rationale/Significance: Breast cancer incidence in rural areas is higher than in urban areas. In addition to higher incidences of breast cancer and other illnesses (e.g., depression rate is double), rural women throughout the U.S. have fewer medical and mental health services than do urban women to assist them during their breast cancer experience resulting in poorer health outcomes (American Psychological Association (APA), 2001). There is also convincing evidence that depressive symptoms and fatigue are linked in cancer patients, and that both symptoms increase following treatment. Interpersonal counseling interventions have been shown to be effective with depressive symptoms, with some evidence that counseling is effective in chronic fatigue. The proposed intervention should improve management of depressive symptoms and fatigue. With improved symptom management, the women should report improved quality of life.
Conceptual Framework: The conceptual framework for this study is based on cognitive-behavioral and interpersonal theory and the common sense model of symptom management.
Design: The design is a repeated measures experimental design.
Sample: The sample consists of rural women who are receiving treatment for breast cancer and their partners. All participants are over 21 years, English speaking, and have access to a telephone. About 60% of the women are white, non-Hispanic and about 40% are Mexican-American.
Main Research Variable(s): Depressive symptoms, fatigue, quality of life.
Methods: The women were randomly assigned to either the TIP-C intervention or usual care control, and matched for stage and treatment type. The TIP-C intervention consisted of six individual telephone sessions with the women. Approximate time was 30 minutes per session. The women in usual care received six 10-minute phone calls to equalize the number of phone calls for each group. Regardless of group assignment, the women completed questionnaires over the telephone three times. Measurement occurred at baseline during enrollment in the study (T1), at the end of the intervention (T2), and one-month after the intervention (T3).
Findings/Conclusions: Data analysis includes descriptive statistics, ANOVA, and multivariate techniques. Preliminary findings date document improved symptom management and quality of life for the TIP-C women.
Implications for Practice: Telephone interpersonal counseling may provide a cost-effective quality intervention for rural women with breast cancer. Nurses are ideally suited to provide this intervention to assist rural women in managing cancer-related symptoms and in improving quality of life.
Funding: ONS Foundation.
Back to Reducing Health Disparity: Barriers to Health Care Utilization
Back to The Advancing Nursing Practice Excellence: State of the Science