Bridge et al

What was the background context of Bridge et al. (1988)?

Cancer diagnosis and treatment cause severe stress. Stress affects both patients and families. Relaxation and imagery had shown benefits for stress reduction in other conditions such as hypertension.

What was the main theory behind the study?

Relaxation involving muscle relaxation and deep breathing reduces stress by calming the body. Imagery involving visualising peaceful scenes creates safety and calm. Combining both enhances stress management.

What was the aim of Bridge et al. (1988)?

To test the effect of relaxation and imagery on stress in breast cancer patients undergoing radiotherapy.

What was the hypothesis?

Women who received relaxation plus imagery training would have greater improvements than those receiving relaxation only or no intervention.

What was the research method and design?

Randomised control trial with field experiment.

What was the sample?

139 women under 70 receiving a 6 week radiotherapy course for early stage breast cancer in a London hospital.

What procedure was followed?

Random allocation to three groups: control with no training ; relaxation only ; relaxation plus imagery. Mood questionnaires before radiotherapy, after one session, and after six weeks. Intervention groups taught relaxation and imagery and given a 15 min tape to use daily. Weekly 30 min sessions with researcher: practice for intervention groups, discussion only for control. Measures included PMSQ and LGS for anxiety and depression.

What were the results?

Relaxation plus imagery group showed greatest improvement in mood disturbance. Relaxation also improved mood. Control group mood worsened.

What subgroup differences were found?

Relaxation plus imagery more effective for women aged 55 plus. Patients with high initial anger responded less positively.

What was the conclusion?

Relaxation and imagery reduce stress in cancer patients especially when combined. Psychological interventions improve wellbeing during treatment.

GRAVE - Generalisability?

Moderate generalisability ; large sample but only women with breast cancer in one UK hospital.

GRAVE - Reliability?

High because of randomisation, control group, standardised tapes, replicable design.

GRAVE - Applicability?

Highly applicable because stress management is vital for cancer and other chronic conditions.

GRAVE - Validity?

High ecological validity with real patients in real hospital.

GRAVE - Ethics?

Ethical concerns because control group stress worsened without intervention which may have breached protection from harm.