Volume 28, Issue 11 pp. 2210-2217
PAPER

A single-session acceptance and commitment therapy intervention among women undergoing surgery for breast cancer: A randomized pilot trial to reduce persistent postsurgical pain

Katherine Hadlandsmyth

Corresponding Author

Katherine Hadlandsmyth

Department of Anesthesia, Carver College of Medicine, University of Iowa, Iowa City, Iowa

Correspondence

Katherine Hadlandsmyth, PhD; Department of Anesthesia, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242.

Email: [email protected]

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Lilian N. Dindo

Lilian N. Dindo

Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas

Center for Innovations, Quality, and Effectiveness, Michael E. Debakey Veterans Affairs Medical Center, Houston, Texas

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Roohina Wajid

Roohina Wajid

College of Nursing, University of Iowa, Iowa City, Iowa

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Sonia L. Sugg

Sonia L. Sugg

Department of Surgery, Carver College of Medicine, University of Iowa, Iowa City, Iowa

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M. Bridget Zimmerman

M. Bridget Zimmerman

College of Public Health, University of Iowa, Iowa City, Iowa

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Barbara A. Rakel

Barbara A. Rakel

College of Nursing, University of Iowa, Iowa City, Iowa

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First published: 20 August 2019
Citations: 30

Abstract

Objective

Oncologic breast surgeries carry a risk for persistent postsurgical pain. This study was a randomized pilot and feasibility study of a single-session Acceptance and Commitment Therapy (ACT) intervention compared with treatment as usual among women undergoing surgery for breast cancer or ductal carcinoma in situ.

Methods

Participants were recruited via letter of invitation and follow-up phone call from a single site in the United States from 2015 to 2017. Participants were at risk for persistent postsurgical pain, based on young age (<50), a preexisting chronic pain condition, or elevated anxiety, depression, or pain catastrophizing.

Results

The 54 participants were female with a mean age of 52.91 years (SD=11.80). At 3-month postsurgery, 11% of the sample reported moderate-severe pain (>3 on a 0-10 numeric rating scale) in the operative breast or with arm movement. Written qualitative responses indicated that the majority of participants who received the intervention understood the concepts presented and reported continued practice of exercises learned in the session. The between group effect sizes for moderate-severe pain and elevated anxiety at 3-month post-surgery were small (Phi=0.08 and 0.16, respectively). The between group effect sizes for depression, pain acceptance, and pain catastrophizing at 3-month postsurgery were minimal.

Conclusions

This study found small positive effects on postsurgical pain and anxiety for a single-session ACT intervention among women with breast cancer. This study supports the use of ACT with this population.

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