Skip to main content

Advertisement

SpringerLink
Log in

Responsiveness to change to change due to supportive-expressive group therapy, improvement in mood and disease progression in women with metastatic breast cancer

  • Original Paper
  • Published:
Quality of Life Research Aims and scope Submit manuscript

An Erratum to this article was published on 18 August 2007

Abstract

Objective

To compare the responsiveness of six questionnaires using three hypotheses of change: (i) change due to supportive-expressive group therapy (SEGT), (ii) improved mood defined as a small effect size (.2) on Profile of Mood States (POMS) Total Mood Disturbance score and (iii) progression of disease.

Method

Data from the “Breast Expressive-Supportive Therapy” study, a multicentre randomized controlled trial of change due to SEGT versus standard of care in women with metastatic breast cancer were used. Questionnaires studied were: POMS, Impact of Event Scale, Psychosocial Adjustment to Illness Scale (PAIS), EORTC QLQ-C30, Mental Adjustment to Cancer and a Pain visual analog scale (VAS). Responsiveness to change was evaluated using the standardized response mean. POMS was used as the standard.

Results

POMS was the most responsive questionnaire to change due to SEGT. Questionnaires measuring psychosocial attributes were responsive to improvement in mood. EORTC QLQ-C30, PAIS, PAIN VAS and MAC were the most responsive to disease progression. More responsive questionnaires were associated with the smallest sample size required to detect an effect.

Conclusions

Responsiveness to change is context specific. The POMS was the most responsive questionnaire to psychosocial therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

POMS:

Profile of Mood States

PAIS:

Psychosocial Adjustment to Illness Scale

QOL:

Quality of life

SEGT:

Supportive-expressive group therapy

HRQOL:

Health-related quality of life

MAC:

Mental adjustment to cancer

IES:

Impact of Event Scale

EORTC QLQ-C30:

EORTC Core Quality of Life Questionnaire-Core 30

TMD:

Total Mood Disturbance

ES:

Effect size

SRM:

Standardized response mean

SD:

Standard deviation

ECOG:

Eastern Cooperative Oncology Group

INT:

Intervention arm

CTL:

Control arm

DIFF:

Difference

References

  1. de Bruin, A. F., Diederiks, J. P., de Witte, L. P., et al. (1997). Assessing the responsiveness of a functional status measure: The sickness impact profile versus the SIP68. Journal of Clinical Epidemiology, 50, 529–540.

    Article  PubMed  Google Scholar 

  2. Kirshner, B., & Guyatt, G. (1985). A methodological framework for assessing health indices. Journal of Chronic Diseases, 38, 27–36.

    Article  Google Scholar 

  3. Liang, M. H., Lew, R. A., Stucki, G., et al. (2002). Measuring clinically important changes with patient-oriented questionnaires. Medical Care, 40(4 Suppl), II45–51.

    PubMed  Google Scholar 

  4. Liang, M. H. (2000). Longitudinal construct validity: establishment of clinical meaning in patient evaluative instruments. Medical Care, 38(9 Suppl), II84–90.

    PubMed  CAS  Google Scholar 

  5. Cella, D., Bullinger, M., Scott, C., et al. (2002). Group vs individual approaches to understanding the clinical significance of differences or changes in quality of life. Mayo Clinic Proceedings, 77, 384–392.

    Article  PubMed  Google Scholar 

  6. Kissane, D. W., Grabsch, B., Love, A., et al. (2004). Psychiatric disorder in women with early stage and advanced breast cancer: A comparative analysis. The Australian and New Zealand Journal of Psychiatry, 38, 320–326.

    Article  PubMed  Google Scholar 

  7. Lloyd-Williams, M., & Friedman, T. (2001). Depression in palliative care patients–a prospective study. European Journal of Cancer Care, 10, 270–274.

    Article  Google Scholar 

  8. Zabora, J., BrintzenhofeSzoc, K., Curbow, B., et al. (2001). The prevalence of psychological distress by cancer site. Psychooncology, 10, 19–28.

    Article  PubMed  CAS  Google Scholar 

  9. Spiegel, D., & Bloom, J. R. (1983). Group therapy and hypnosis reduce metastatic breast carcinoma pain. Psychosomatic Medicine, 45, 333–339.

    Google Scholar 

  10. Spiegel, D., Bloom J. R., & Yalom, I. (1981). Group support for patients with metastatic cancer. A randomized outcome study. Archives of General Psychiatry, 38, 527–533.

    PubMed  CAS  Google Scholar 

  11. Cunningham, A. J., Edmonds, C. V., Jenkins, G. P., et al. (1998). A randomized controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer. Psychooncology, 7, 508–517.

    Article  PubMed  CAS  Google Scholar 

  12. Edelman, S., Lemon, J., Bell, D. R., et al. (1999). Effects of group CBT on the survival time of patients with metastatic breast cancer. Psychooncology, 8, 474–481.

    Article  PubMed  CAS  Google Scholar 

  13. Goodwin, P. J., Leszcz, M., Ennis, M., et al. (2001). The effect of group psychosocial support on survival in metastatic breast cancer. The New England Journal of Medicine, 345, 1719–1726.

    Article  PubMed  CAS  Google Scholar 

  14. Hewitt, M., Herdman, R., & Holland, J. (Eds.) (2004). Meeting psychosocial needs of women with breast cancer (1st ed., p. 278). Washigton: The National Academy Press.

  15. Bordeleau, L., Szalai, J. P., Ennis, M., et al. (2003). Quality of life in a randomized trial of group psychosocial support in metastatic breast cancer: overall effects of the intervention and an exploration of missing data. Journal of Clinical Oncology, 21, 1944–1951.

    Article  PubMed  Google Scholar 

  16. Classen, C., Diamond, S., Soleman, A., et al. (1993). Brief supportive-expressive group therapy for women with primary breast cancer: A treatment manual. Stanford: Stanford University School of Medicine, p. 55.

    Google Scholar 

  17. McNair D. L. M., & Droppleman, L. F. (1992). EdITS manual for the Profile of Mood States. San Diego, California 92167: EdITS/Educational and industrial testing service.

    Google Scholar 

  18. Goodwin, P. J., Black, J. T., Bordeleau, L. J., et al. (2003). Health-related quality-of-life measurement in randomized clinical trials in breast cancer–taking stock. Journal of the National Cancer Institute, 95, 263–281.

    Article  PubMed  Google Scholar 

  19. Classen, C., Butler, L. D., Koopman, C., et al. (2001). Supportive-expressive group therapy and distress in patients with metastatic breast cancer: A randomized clinical intervention trial. Archives of General Psychiatry, 58, 494–501.

    Article  PubMed  CAS  Google Scholar 

  20. Taylor, S. E., Lichtman, R. R., Wood, J. V., et al. (1985). Illness-related and treatment-related factors in psychological adjustment to breast cancer. Cancer, 55, 2506–2513.

    Article  PubMed  CAS  Google Scholar 

  21. Watson, M., Greer, S., & Bliss, J. M. (1989) Mental Adjustment to Cancer (MAC) scale users’ manual.

  22. Andritsch, E., Goldzweig, G., Samonigg, H., et al. (2004). Changes in psychological distress of women in long-term remission from breast cancer in two different geographical settings: A randomized study. Support Care Cancer, 12, 10–18.

    Article  PubMed  CAS  Google Scholar 

  23. Watson, M., Haviland, J. S., Greer, S., et al. (1999). Influence of psychological response on survival in breast cancer: A population-based cohort study. Lancet, 354, 1331–1336.

    Article  PubMed  CAS  Google Scholar 

  24. Sundin, E. C., & Horowitz, M. J. (2003). Horowitz’s Impact of Event Scale evaluation of 20 years of use. Psychosomatic Medicine, 65, 870–876.

    Article  Google Scholar 

  25. Kaasa, S., Malt, U., Hagen, S., et al. (1993). Psychological distress in cancer patients with advanced disease. Radiotherapy and Oncology, 27, 193–197.

    Article  PubMed  CAS  Google Scholar 

  26. Derogatis L. R., McNair D. M., The psychosocial adjustment to illness scale (PAIS & PAIS-SR). Administration, scoring & procedures manual-II. 1990, U.S.A.

  27. Friedman, L. C., Baer, P. E., Nelson, D. V., et al., (1988). Women with breast cancer: Perception of family functioning and adjustment to illness. Psychosomatic Medicine, 50, 529–540.

    PubMed  CAS  Google Scholar 

  28. Merluzzi, T. V., &. Martinez Sanchez. M. A., (1997). Factor structure of the psychosocial adjustment to illness scale (self-report) for persons with cancer. Psychological Assessment, 9, 269–276.

    Google Scholar 

  29. Aaronson, N. K., Ahmedzai, S., Bergman, B., et al., (1993). The European organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85, 365–376.

    Article  PubMed  CAS  Google Scholar 

  30. Bottomley, A., Biganzoli, L., Cufer, T., et al., (2004). Randomized, controlled trial investigating short-term health-related quality of life with Doxorubicin and Paclitaxel versus Doxorubicin and cyclophosphamide as first-line chemotherapy in patients with metastatic breast cancer: European organization for research and treatment of cancer breast cancer group, investigational drug branch for breast cancer and the new drug development group study. Journal of Clinical Oncology, 22, 2576–2586.

    Article  PubMed  CAS  Google Scholar 

  31. McLachlan, S. A., Devins G. M., & Goodwin, P. J. (1998). Validation of the European organization for research and treatment of cancer quality of life questionnaire (QLQ-C30) as a measure of psychosocial function in breast cancer patients. European Journal of Cancer, 34, 510–517.

    Article  PubMed  CAS  Google Scholar 

  32. Hjermstad, M. J., Fossa, S. D., Bjordal, K., et al., (1995). Test/retest study of the European organization for research and treatment of cancer core quality-of-life questionnaire. Journal of Clinical Oncology, 13, 1249–1254.

    PubMed  CAS  Google Scholar 

  33. Osoba, D., Rodrigues, G., Myles, J., et al., (1998). Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology, 16, 139–144.

    PubMed  CAS  Google Scholar 

  34. Clark, P., Lavielle P., & Martinez, H., (2003). Learning from pain scales: Patient perspective. The Journal of Rheumatology, 30, 1584–1588.

    PubMed  Google Scholar 

  35. Cohen J., (1988). Statistical power analysis for the behavioral sciences. (2nd ed, p. 567). Hillsdale, New Jersey: Lawrence Erlbaum Associates.

  36. Samsa, G., Edelman, D., Rothman, M. L., et al., (1999). Determining clinically important differences in health status measures: A general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics, 15, 141–155.

    Article  PubMed  CAS  Google Scholar 

  37. Geels, P., Eisenhauer, E., Bezjak, A., et al., (2000). Palliative effect of chemotherapy: Objective tumor response is associated with symptom improvement in patients with metastatic breast cancer. Journal of Clinical Oncology, 18, 2395–2405.

    PubMed  CAS  Google Scholar 

  38. Zou, G. Y., (2005). Quantifying responsiveness of quality of life measures without an external criterion. Quality of Life Research, 14, 1545–1552.

    Article  PubMed  Google Scholar 

  39. Lemieux, J., Beaton, D. E., S. Hogg-Johnson, et al., (2006). Three methods for minimally important difference: No relationship was found with the net proportion of patients improving. Journal of Clinical Epidemiology (in press).

  40. Schwartz, C. E., Bode, R., Repucci, N., et al., (2006). The clinical significance of adaptation to changing health: A meta-analysis of response shift. Quality of Life Research, 15, 1503–1508.

    Article  PubMed  Google Scholar 

  41. Holzner, B., Kemmler, G., Sperner-Unterweger, B., et al., (2001). Quality of life measurement in oncology–a matter of the assessment instrument? European Journal of Cancer, 37, 2349–2356.

    Article  PubMed  CAS  Google Scholar 

  42. Wilson, R. W., Hutson L. M., & Vanstry, D. (2005). Comparison of 2 quality-of-life questionnaires in women treated for breast cancer: The RAND 36-Item Health Survey and the Functional Living Index-Cancer. Physical Therapy, 85, 851–860.

    PubMed  Google Scholar 

Download references

Acknowledgements

Dr Lemieux was supported on a Canadian Institutes of Health Research (CIHR)/Canadian Association of Medical Oncologists/ Rx&D Research fellowship program and Université Laval fellowship program.

Dr Beaton is supported on a CIHR New Investigator’s Award.

The research was funded by the CIHR and the Canadian Breast Cancer Research Alliance.

Author information

Authors and Affiliations

  1. Unité de recherche en santé des populations, Centre hospitalier affilié universitaire de Québec, pavillon St-Sacrement, Quebec, Canada

    Julie Lemieux

  2. Département de Médicine, de l’Université Laval, Quebec, Canada

    Julie Lemieux

  3. Samuel Lunenfeld Research Institute of the Mount Sinai Hospital, Quebec, Canada

    Julie Lemieux

  4. Université Laval, Quebec, Canada

    Julie Lemieux

  5. Unité de recherche en santé des populations, Centre de Recherche, Hôpital St-Sacrement, du Centre Hospitalier affilié de l’Université Laval, 1050 Chemin Ste-Foy, Room JS1-01, Quebec, QC, Canada, G1S 4L8

    Julie Lemieux

  6. Mobility Program, Clinical Research Unit, St Michael’s Hospital, Toronto, Canada

    Dorcas E. Beaton

  7. Institute for Work and Health, Toronto, Canada

    Sheilah Hogg-Johnson

  8. Department of Medicine, Mount Sinai Hospital, Toronto, Canada

    Louise J. Bordeleau

  9. Department of Psychiatry, Mount Sinai Hospital, Toronto, Canada

    Jon Hunter

  10. Department of Medicine, Samuel Lunenfeld Research Institute of the Mount Sinai Hospital, Toronto, Canada

    Pamela J. Goodwin

  11. University of Toronto, Toronto, Canada

    Dorcas E. Beaton, Sheilah Hogg-Johnson, Louise J. Bordeleau, Jon Hunter & Pamela J. Goodwin

Authors
  1. Julie Lemieux
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dorcas E. Beaton
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sheilah Hogg-Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Louise J. Bordeleau
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jon Hunter
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pamela J. Goodwin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julie Lemieux.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s11136-007-9253-x

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lemieux, J., Beaton, D.E., Hogg-Johnson, S. et al. Responsiveness to change to change due to supportive-expressive group therapy, improvement in mood and disease progression in women with metastatic breast cancer. Qual Life Res 16, 1007–1017 (2007). https://doi.org/10.1007/s11136-007-9208-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-007-9208-2

Keywords

Search

Navigation