A workbook-journal for women with breast cancer: promoting psychological adjustment after treatment completion.

INTERVENTION: One intervention was developed for the purpose of the study. This comprised a self‐help workbook entitled “Women Moving On: A workbook journal for women moving forward after treatment for breast cancer”. Self‐management interventions have recently become a research focus, as they offer the benefits of being used in patients' own time, they overcome geographical barriers to attending psychological therapy, and are cost effective. The interactive workbook developed for this study provides information, suggestions and worksheets, a relaxation/meditation tape, survivors’ stories, and opportunities for journal writing. The resource was based on themes derived from a series of focus‐groups with breast cancer survivors (Oxlad et al., in press). The workbook was based on cognitive‐behavioural strategies and emotional‐expression, and encouraged women to actively process and engage in issues of relevance to them. It contained sections on (i) maintaining the medical partnership, (ii) physical well‐being, (iii) feeling alone, (iv) family and friends, (v) emotional recovery, (vi) spirituality, (vii) seeking closure, (viii) moving forward, (ix) living the life you want, and (x) local and national resources. Some of the themes for the workbook were suggested by a previously evaluated American workbook (Angell et al., 2003). Participants were encouraged to read sections of the workbook over the course of 3 months. Participants in the treatment condition were contacted after 4‐ and 8‐weeks in order to receive qualitative feedback about the workbook. CONDITION: Breast Cancer PRIMARY OUTCOME: Examining if a significant change occurred in the following coping measures relative to the control group: Planning, Restraint, Seeking Social Support (Instrumental, Emotional), Turning to Religion, Venting Emotions, & Denial. SECONDARY OUTCOME: Examining if a significant change occurred in the following distress and quality of life domains relative to the control group: Centre for Epidemiological Studies (CESD)Depression scale, Depression Anxiety Stress Scales (DASS) Anxiety subscale, Posttraumatic Stress Scale‐Self Report (PSS‐SR) Traumatic Stress Scale, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire‐Cancer 30 items (QLQ‐C30) Global quality of life (QOL) scale and 5 functional subscales (physical, role, cognitive, social, emotional), and Breast‐23 item Specific Module (BR‐23) Body Image Scale. INCLUSION CRITERIA: Diagnosis of Primary Breast Cancer (Stages I‐II), completed active treatment (surgery, radiotherapy, chemotherapy), aged 18 years or over, able to read sufficient English to be able to use the workbook.