RAWL – VOL 29, NO 6, 2002 967 Susan M. Rawl, PhD, RN, is an assistant professor in the School of Nursing at Indiana University in Indianapolis; Barbara A. Given, PhD, RN, FAAN, is a university distinguished professor at Michigan State University in East Lansing; Charles W. Given, PhD, is a pro- fessor at Michigan State University; Victoria L. Champion, DNS, RN, FAAN, is an associate dean for research in the School of Nursing at Indiana University and the director of Cancer Contol for Indiana Uni- versity Cancer Center; Sharon L. Kozachik, MSN, RN, is a research assistant at Michigan State University; Debra Barton, MSN, RN, is a research scientist at Mayo Clinic in Rochester, MN; at the time this article was written, Christine L. Emsley, MS, was a biostistician at In- diana University; and Stephen D. Williams, MD, is a professor in the School of Medicine at Indiana University and director for the Indiana University Cancer Center. This research was conducted in affiliation with the Walther Cancer Institute in Indianapolis. (Submitted Janu- ary 2000. Accepted for publication June 29, 2001.) Digital Object Identifier: 10.1188/02.ONF.967-975 Intervention to Improve Psychological Functioning for Newly Diagnosed Patients With Cancer Susan M. Rawl, PhD, RN, Barbara A. Given, PhD, RN, FAAN, Charles W. Given, PhD, Victoria L. Champion, DNS, RN, FAAN, Sharon L. Kozachik, MSN, RN, Debra Barton, MSN, RN, Christine L. Emsley, MS, and Stephen D. Williams, MD Key Points . . . ➤ Newly diagnosed patients with cancer exhibit psychosocial distress, including anxiety and depression. ➤ A computer-based nursing intervention can be used to docu- ment and standardize cancer-care delivery. ➤ A computer-based nursing intervention may improve psycho- social functioning, depression, and anxiety for newly diag- nosed patients with cancer undergoing chemotherapy. ➤ Patients with cancer who are most in need of psychosocial in- terventions may be more likely to drop out of intervention studies. Purpose/Objectives: To test the effects of a computer- based nursing intervention designed to provide patients and family caregivers with concrete, objective information on symptom management; provide education about dis- ease and treatment; coordinate medical resources; and provide emotional support and counseling. Design: Two-site, randomized clinical trial. Settings: A large, urban, midwestern, tertiary-cancer center and a community-based cancer center in a me- dium-sized midwestern city. Sample: 109 patients newly diagnosed with breast, co- lon, or lung cancer who were receiving chemotherapy; 54 received standard care, and 55 participated in the inter- vention group. Methods: Outcome data were collected via structured telephone interviews at three time points: baseline, mid- way through the intervention, and one month postinter- vention. The intervention consisting of nine visits, five in person and four by telephone, was conducted over 18 weeks by advanced practice oncology nurses. Main Research Variables: Psychosocial functioning, anxi- ety, and depression. Findings: Patients who received the intervention had sig- nificantly less depression between baseline and the mid- way point, as well as less anxiety and greater improvement in the role-emotional and mental health subscales of the Medical Outcomes Study 36 Short Form. Conclusions: Cancer-care nursing interventions can decrease psychosocial morbidity and improve quality of life for newly diagnosed patients with cancer undergoing treatment. Additional research is needed to understand who benefited most from the intervention. Implications for Nursing: This nurse-directed intervention resulted in improved mental health for patients; however, physical subscales were not changed. Further work is needed to determine why depression and mental health were affected yet physical health and symptoms did not differ between groups. Results support the important role of nurses in addressing mental health issues in patients and families experiencing cancer. N ewly diagnosed patients with cancer frequently struggle to cope with diagnosis, treatment, and sur- vival, often with limited resources, creating physical, psychological, and financial burdens. Hospital stays have been shortened, limiting the time patients and caregivers have to learn care tasks (e.g., administering medications and treat- ments, managing and monitoring symptoms). Coping at home with cancer-treatment-related symptoms, such as fatigue and pain, presents tremendous challenges for patients and their families and may contribute to psychological dysfunction, such as depression and anxiety (Schag & Heinrich, 1989). The purpose of this pilot study was to test a computer-based nursing intervention that provided assistance with symptom management, information about disease and treatment, emo- tional counseling and support, and coordination of services to newly diagnosed patients and their families who are dealing with cancer and chemotherapy treatment. Providing patients This material is protected by U.S. copyright law. Unauthorized reproduction is prohibited. 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