Efficacy of a Spanish-Language Self-Administered Stress Management Training Intervention for Latinas Undergoing Chemotherapy

Abstract

Background

Cancer patients often report increased stress during chemotherapy. Stress management training has been shown to reduce this adverse outcome, but few interventions exist for Spanish-speaking Hispanic and Latina women (Latinas).

Methods

Following community feedback (including focus groups/in-depth interviews), we transcreated the Spanish-Language Self-Administered Stress Management Training (SL-SAT) intervention based on our previously developed and implemented English-based intervention. Latinas about to begin chemotherapy were randomized to SL-SAT (n=121) or usual care (UC; n=119). A Spanish-speaking interventionist met with SL-SAT participants who received the SL-SAT toolkit containing instructions in three well-established stress management techniques (deep breathing, progressive muscle relaxation and guided imagery, and use of coping self-statements). UC participants received an educational booklet about coping with chemotherapy. All patients were instructed by nurses on their chemotherapy medications and given a resource listing of local support groups. Outcomes were obtained at baseline, and 7 and 13 weeks after starting chemotherapy. Primary outcomes included anxiety and depression, cancer-related distress, emotional well-being, and spiritual well-being. Secondary outcomes included functional well-being, social/family well-being, physical well-being, symptom severity, and self-efficacy for managing stress. Data were analyzed using mixed models.

Results

In both groups, improvements were observed in emotional well-being (p=.01), and declines were observed in functional well-being (p=.05), and physical well-being (p<.0001). Symptom severity increased across the follow-up period (p<.001).

Conclusions

To be effective, stress management interventions for Latinas receiving chemotherapy may necessitate more attention from an interventionist, delivery of the intervention over a longer interval, and/or a group-based format.

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