ArticlesThe Effectiveness of the Comprehensive Coping Strategy Program on Clinical Outcomes in Breast Cancer Autologous Bone Marrow TransplantationGaston-Johansson, Fannie Dr.Med.Sc., R.N., F.A.A.N.; Fall-Dickson, Jane M. R.N., M.S.N., A.O.C.N.; Nanda, Joy M.S., M.H.S.; Ohly, Karen V. R.N., M.S.N.; Stillman, Susan M.S.W.; Krumm, Sharon Ph.D., R.N.; Kennedy, M. John M.B., F.R.C.P.I.Author Information Fannie Gaston-Johansson is Professor and Director, International and Extramural Programs, Johns Hopkins University School of Nursing, Baltimore, Maryland. Jane M. Fall-Dickson is a Research Assistant and Doctoral Candidate at Johns Hopkins University School of Nursing, Baltimore, Maryland. Joy Nanda is a Doctoral Candidate at Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland. Karen V. Ohly is a BMT Clinical Nurse Specialist at Johns Hopkins Hospital, Baltimore, Maryland. Susan Stillman is an Oncology Clinical Social Worker. Sharon Krumm is Director of Nursing Function Unit, Oncology Nursing, Johns Hopkins Hospital, Baltimore, Maryland. M. John Kennedy is an Associate Professor in the Department of Hematology and Oncology, University of Dublin, Trinity College, St. James’ Hospital, Dublin, Republic of Ireland. Address correspondence and reprint requests to Dr. Fannie Gaston-Johansson, International and Extramural Programs, Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD 21205-2110. Accepted for publication February 23, 2000. Cancer Nursing: August 2000 - Volume 23 - Issue 4 - p 277-285 Buy Abstract Patients with breast cancer who undergo autologous bone marrow/peripheral blood stem cell transplantation (ABMT) cope not only with a life-threatening medical treatment, but also with multiple, interrelated symptoms including pain, fatigue, psychological distress, and nausea. The purpose of this study was to determine, in a randomized controlled clinical trial, whether a comprehensive coping strategy program (CCSP) was effective in significantly reducing pain, fatigue, psychological distress, and nausea in patients with breast cancer who underwent ABMT. The CCSP was composed of preparatory information, cognitive restructuring, and relaxation with guided imagery. Randomization placed 52 patients in the CCSP treatment group and 58 patients in the control group. The CCSP was found to be effective in significantly reducing nausea as well as nausea combined with fatigue 7 days after the ABMT when the side effects of treatment were most severe. These results are important given the high incidence of nausea and fatigue in the ABMT population. The CCSP-treated group experienced mild anxiety as compared with the control group who reported moderate anxiety. The greatest effectiveness of CCSP may correspond to the time of the greatest morbidity for patients with breast cancer who have undergone ABM. © 2000 Lippincott Williams & Wilkins, Inc.