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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Colorectal cancer patients endure physical declines which interfere with social functioning. Fatigue, pain, and bowel problems impact routine social activities. Sexual side effects disrupt the intimacy of spousal relationships. Changes intensify for older patients with diminished social networks. According to the Social Cognitive Processing Model, social support can have a significant effect on psychological well-being, as it may facilitate cognitive processing of the cancer experience, thereby promoting emotional adaptation. However, side effects may be difficult or embarrassing to discuss; patients may refrain from discussing them to avoid negative social responses. Inhibiting emotional expression can hinder cognitive processing, resulting in psychological distress. Psychological problems can compromise medical outcomes, and if untreated, can develop into clinical disorders resulting in social isolation and reduced quality of life (QOL). Group-based psychosocial programs may effectively improve mood and social support for colorectal cancer patients by encouraging emotional disclosure, thereby facilitating effective cognitive processing. There has been no study of support group interventions with colorectal cancer patients. Since support groups are a standard psychosocial referral for cancer patients, effective group programs based on sound theoretical frameworks must be developed, and mediators for intervention effectiveness must be identified. A novel technology called the Electronically Activated Recorder (EAR) proposes to be a promising means for studying these mediators and overcomes the limitations of self-report measures. We will develop and assess the feasibility of an Expressive Disclosure Group Program for colorectal cancer patients and pilot test the EAR technology. If effective, our Expressive Disclosure Program may provide a low cost, easily disseminated means for targeting psychological functioning and QOL in colorectal cancer patients. We propose a two-part study including a descriptive study of colorectal cancer patients for the purpose of developing the Expressive Disclosure Group Program and a small randomized feasibility study of this program. A total of 64 colorectal cancer patients will be recruited for both parts of the study. The specific aims are to: (1) conduct a descriptive study of colorectal cancer patients in an effort to assess QOL issues and preferences regarding intervention format and logistics; (2) use the information to develop an Expressive Disclosure Group Program; (3) pilot test a novel technology called the EAR for assessing social support and cognitive processing and compare these data to self-report measures; (4) pilot test the Expressive Disclosure Group Program and conduct process evaluation including rates of recruitment and retention, attendance, satisfaction, barriers and feasibility of randomization; and (5) explore the effects of the Expressive Disclosure Group Program on the outcome variables of QOL and psychological functioning and on the mediating variables of cognitive processing, coping skills, and social support.