Supportive Care in Cancer

, Volume 14, Issue 12, pp 1213–1219 | Cite as

Stress and intervention preferences of patients with brain tumors

  • Stephen T. Keir
  • Ann Bebe Guill
  • Karen E. Carter
  • Henry S. Friedman
Original Article



Despite advances in diagnosis, treatment, and management of brain tumors, a brain tumor (BT) can significantly disrupt a person’s life and create stress. To design effective stress reduction interventions, it is essential to have an understanding of the beliefs, past experiences, and preferences concerning stress reduction techniques and programs among patients with BTs.

Materials and methods

Using a convenience sample, 60 adult patients with primary BTs completed the study questionnaire. Demographic information and patient preferences were collected using self-reported measures, medical information was collected via medical chart review, and stress was assessed using Perceived Stress Scale.


Sixty-three percent of the population sampled experienced elevated levels of stress. Eighty-six percent wanted to learn about techniques to reduce stress and 78% believed stress reduction techniques can help reduce stress. However, only 56% indicated they would be able to participate in a stress reduction program twice a week and only 40% of the sample wanted to participate in the various stress reduction programs presented to them in this study. Furthermore, only 26% of the sample actually wanted to receive information about stress reduction programs and only 25% would participate in programs using the various modes presented.


The results of this study clearly indicate that patients with BTs experience stress. Furthermore, the data is encouraging in regard to the patients’ desire to learn about stress reduction techniques. However, the lack of interest in actually receiving information and the inability to envision themselves participating in programs present a major challenge.


Brain tumors Stress Intervention preferences 


  1. 1.
    Andersen BL, Kiecolt-Glaser JK, Glaser R (1994) A biobehavioral model of cancer stress and disease course. Am Psychol 49:389–404CrossRefPubMedGoogle Scholar
  2. 2.
    Boon H, Brown J, Gavin A (2000) What are the experiences of women with breast cancer as they decide whether to use complementary/alternative medicine? West J Med 73:39CrossRefGoogle Scholar
  3. 3.
    Carlson LE, Bultz BD (2003) Benefits of psychosocial oncology care: improved quality of life and medical cost offset. Health Qual Life Outcomes 1:8CrossRefPubMedGoogle Scholar
  4. 4.
    Carlson LE, Bultz BD (2003) Cancer distress screening: needs, methods and models. J Psychosom Res 55:403–409CrossRefPubMedGoogle Scholar
  5. 5.
    Carney RM, Freedland KE (2002) Psychological distress as a risk factor for stroke-related mortality. Stroke 33:5–6PubMedGoogle Scholar
  6. 6.
    Cassileth BR, Chapman CC (1996) Alternative and complementary cancer therapies. Cancer 77:1026–1034CrossRefPubMedGoogle Scholar
  7. 7.
    Cohen S, Karmarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24:385–396CrossRefPubMedGoogle Scholar
  8. 8.
    Cwikel JG, Behar LC, Zabora JR (1997) Psychosocial factors that affect the survival of adult cancer patients: a review of research. J Psychosoc Oncol 15:1–34CrossRefGoogle Scholar
  9. 9.
    Demark-Wahnefried W, Peterson B, McBride C, Lipkus I et al (2000) Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas. Cancer 88:674–684CrossRefPubMedGoogle Scholar
  10. 10.
    Fawzy FI, Fawzy NW, Arndt LA (1995) Critical review of psychosocial interventions in cancer care. Arch Gen Psychiatry 52:100–113PubMedGoogle Scholar
  11. 11.
    Ganz PA (2002) Breast cancer 2002: where do we stand? CA Cancer J Clin 52:253–255PubMedCrossRefGoogle Scholar
  12. 12.
    Giovagnoli AR, Silvani A, Colombo E et al (2005) Facets and determinants of quality of life in patients with recurrent high grade glioma. J Neurol Neurosurg Psychiatry 76:562–568CrossRefPubMedGoogle Scholar
  13. 13.
    Green BL, Krupnick JL, Rowland JH et al (2000) Trauma history as a predictor of psychologic symptoms in women with breast cancer. J Clin Oncol 18:1084–1093PubMedGoogle Scholar
  14. 14.
    Jones LW, Courneya KS (2002) Exercise counseling and programming preferences of cancer survivors. Cancer Pract 10:208–215CrossRefPubMedGoogle Scholar
  15. 15.
    Mackereth PA, Stringer J (2005) CAM and cancer care: champions for integration. Complement Ther Clin Pract 1:45–47CrossRefGoogle Scholar
  16. 16.
    McQuellon RP, Wells M, Hoffman S et al (1998) Reducing distress in cancer patients with an orientation program. Psychooncology 7:207–217CrossRefPubMedGoogle Scholar
  17. 17.
    Monti DA, Yang J (2005) Complementary medicine in chronic cancer care. Semin Oncol 32:225–231CrossRefPubMedGoogle Scholar
  18. 18.
    Nano R, Ceroni M (2005) The immunobiology of malignant gliomas. Funct Neurology 20:39–42Google Scholar
  19. 19.
    National Brain Tumor Foundation (2005) Accessed July 1
  20. 20.
    National Comprehensive Cancer Network (NCCN) (2005) Distress management panel definition. Accessed September 25
  21. 21.
    Pelletier G, Verhoef MJ, Khatri N et al (2002) Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues. J Neurooncol 57:41–49CrossRefPubMedGoogle Scholar
  22. 22.
    Penson RT, Partridge RA, Shah MA et al (2005) Fear of death. Oncologist 10:160–169CrossRefPubMedGoogle Scholar
  23. 23.
    Rabkin JG, Wagner GJ, DelBene M (2000) Resilience and distress among amyotrophic lateral sclerosis patients and caregivers. Psychosom Med 62:271–279PubMedGoogle Scholar
  24. 24.
    Remer S, Murphy ME (2004) The challenges of long-term treatment outcomes in adults with malignant gliomas. Clin J Oncol Nurs 8:368–376PubMedGoogle Scholar
  25. 25.
    Speca M, Carlson LE, Goodey E et al (2000) A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med 62:613–622PubMedGoogle Scholar
  26. 26.
    Stjernsward J, Colleau S (1996) The W.H.O. cancer pain and palliative care program: past, present, and future. J Pain Symptom Manage 12:65–66CrossRefPubMedGoogle Scholar
  27. 27.
    Strine TW, Kobau R, Chapman DP et al (2005) Psychological distress, comorbidities, and health behaviors among U.S. adults with seizures: results from the 2002 National Health Interview Survey. Epilepsia 46:1133–1139CrossRefPubMedGoogle Scholar
  28. 28.
    Tallibert S, Laigle-Donadey F, Sanson M (2004) Palliative care in patients with primary brain tumors. Curr Opin Oncol 16:587–592CrossRefPubMedGoogle Scholar
  29. 29.
    Taphoorn MJ (2003) Neurocognitive sequelae in the treatment of low-grade gliomas. Semin Oncol 30:45–48CrossRefPubMedGoogle Scholar
  30. 30.
    Taphoorn MJ, Klein M (2004) Cognitive deficits in adult patients with brain tumours. Lancet Neurol 3:159–168CrossRefPubMedGoogle Scholar
  31. 31.
    VanderCreek L, Rogers E, Lester J (1999) Use of alternative therapies among breast cancer outpatients compared with the general population. Altern Ther Health Med 5:71–76PubMedGoogle Scholar
  32. 32.
    Weitzner MA, Meyers CA (1997) Cognitive functioning and quality of life in malignant glioma patients: a review of the literature. Psychooncology 6:169–177CrossRefPubMedGoogle Scholar
  33. 33.
    Zabora J, Brintzenhofeszoc K, Curbow B, Hooker C (2001) The prevalence of psychological distress by cancer site. Psychooncology 10:19–28CrossRefPubMedGoogle Scholar
  34. 34.
    Zebrack BJ, Gurney JG, Oeffinger K et al (2004) Psychological outcomes in long-term survivors of childhood brain cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol 22:999–1006CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Stephen T. Keir
    • 1
  • Ann Bebe Guill
    • 1
  • Karen E. Carter
    • 1
  • Henry S. Friedman
    • 1
  1. 1.The Tug McGraw Center for Quality of Life/Supportive Care ResearchThe Preston Robert Tisch Brain Tumor Center at Duke University Medical CenterDurhamUSA

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