A stepped care stress management intervention on cancer-related traumatic stress symptoms among breast cancer patients-a randomized study in group vs. individual setting

Rissanen, Ritva; Nordin, Karin; Ahlgren, Johan; Arving, Cecilia

doi:10.1002/pon.3763

Cited by 13 publications

(24 citation statements)

References 40 publications

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“…The Australian Clinical Pathway recommends a stepped‐care model whereby patients should receive the minimum level of psychological treatment that is effective in treating their anxiety, and more intensive psychological treatment in combination with pharmacological treatment should be reserved for patients with severe anxiety . Recently, 3 studies specifically trialled stepped‐care treatments . However, the treatment was ineffective for anxiety in 2 studies.…”

Section: Discussionmentioning

confidence: 99%

“…Braamsee et al attributed this to low intervention uptake or low psychological distress at baseline (prevalence of elevated anxiety symptoms at baseline was only 6.5%) . Rissanen et al mentioned that the intensity of the initial step intervention (stress management education) may have been too low or too similar to easily accessible online information . Moreover, both studies did not screen patients for anxiety or distress.…”

Section: Discussionmentioning

confidence: 99%

“…106 Recently, 3 studies specifically trialled stepped-care treatments. 46,75,86 However, the treatment was ineffective for anxiety in 2 studies. Braamsee et al attributed this to low intervention uptake or low psychological distress at baseline (prevalence of elevated anxiety symptoms at baseline was only 6.5%).…”

Section: Rob Assessmentmentioning

confidence: 99%

“…46 Rissanen et al mentioned that the intensity of the initial step intervention (stress management education) may have been too low or too similar to easily accessible online information. 86 Moreover, both studies did not screen patients for anxiety or distress. The stepped-care approach was genu- Our study provided evidence for factors associated with low intervention effects, which should be considered when planning future clinical trials.…”

Section: Rob Assessmentmentioning

confidence: 99%

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Are psychological interventions effective on anxiety in cancer patients? A systematic review and meta‐analyses

et al. 2018

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Low psychological distress at baseline and nonevidence-based interventions were the main factors identified for low effectiveness. Screening and assessment to determine clinical levels of anxiety in patients with cancer should be considered in future trials as an inclusion criterion before providing psychological interventions. Systematic review registration: PROSPERO: International Prospective Register of Systematic Reviews: CRD42017056132.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Rob Assessmentmentioning

confidence: 99%

Section: Rob Assessmentmentioning

confidence: 99%

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Are psychological interventions effective on anxiety in cancer patients? A systematic review and meta‐analyses

et al. 2018

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“…[8][9][10] Intrusive thoughts and avoidance may be predictors of psychological distress and can therefore be used to identify patients who are at risk of possible future problems involving psychological distress and/or emotional reactivity. 9,[11][12][13] Psychological distress is defined as "a multifactorial unpleasant emotional experience of psychological (cognitive, behavioral, emotional), social, and/or spiritual nature that interfere with the ability to cope with cancer, its physical symptoms and its treatment". 14 It is a subjective experience and includes symptoms such as anxiety and depression.…”

Section: Introductionmentioning

confidence: 99%

Early rehabilitation of cancer patients—An individual randomized stepped‐care stress‐management intervention

et al. 2018

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Objective: To evaluate the effects of an individual stepped-care stressmanagement intervention for cancer patients on cancer-related stress reactions (intrusion/avoidance), and secondarily on psychological distress (anxiety/depression) and emotional reactivity (impatience/hostility). Methods:Consecutively 291 cancer patients were included in a randomized controlled intervention study. Patients randomized to the intervention who did not report clinically significant stress levels (n = 72) after the first counseling session participated in only one counseling session and a follow-up (Step 1). The remaining patients (n = 66) received an additional three to eight sessions, depending on individual needs (Step 2).The intervention used techniques derived from cognitive behavioral therapy (CBT) such as daily registration of events and behaviors as well as scheduled behavioral and physical activity, along with short relaxation exercises. The intervention was completed within 26 weeks of inclusion. The Impact of Event Scale, Hospital Anxiety and Depression Scale, and Everyday Life Stress Scale were used to evaluate effects for 2 years. Results:The linear mixed effects model analysis showed a difference between the randomization groups in favor of the intervention for avoidance and intrusion after the first 6 weeks (P = 0.001 and P = 0.003) and for emotional reactivity after 17 weeks (P = 0.007). There were no differences in psychological distress. Decreases in cancerrelated stress reactions and depression were noted for the Step 2 intervention.Conclusions: An individual stepped-care stress-management intervention for cancer patients, performed by specially educated health professionals using techniques derived from CBT, seems beneficial for cancer patients and may therefore be a realistic complement to routine cancer care. KEYWORDS anxiety, cancer, counseling, depression, life stress, linear mixed effects model, methods derived from cognitive behavioral therapy, oncology, psychological, stress disorders 1 | BACKGROUND There is a call for rehabilitation in cancer care, due to a new situation characterized by a stable rise in the incidence of cancer overall and an increasing number of cancer survivors. 1,2 Based on a holistic approach to rehabilitation and the Model of Functional Health, a theoretical framework of rehabilitation, 3 cancer rehabilitation aims to prevent and reduce the physical, psychological, social, and spiritual consequences of a cancer disease and its treatment. 4Cancer may result in cancer-related stress reactions such as intrusive thoughts (eg, re-experiencing the trauma) and avoidance (eg, denial of the event and emotional numbing). 5-7 Prevalence of intrusive

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Psychological interventions for women with non-metastatic breast cancer

Jassim

Doherty

Whitford

et al. 2023

Cochrane Database of Systematic Reviews

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A stepped care stress management intervention on cancer-related traumatic stress symptoms among breast cancer patients-a randomized study in group vs. individual setting

Abstract: The mode of delivery had no effect on the cancer-related traumatic stress symptoms; however, the individual setting was preferred. In future studies, a preference-based RCT design will be recommended for evaluating the different treatment effects.

Cited by 13 publications

References 40 publications

Are psychological interventions effective on anxiety in cancer patients? A systematic review and meta‐analyses

Are psychological interventions effective on anxiety in cancer patients? A systematic review and meta‐analyses

Early rehabilitation of cancer patients—An individual randomized stepped‐care stress‐management intervention

Psychological interventions for women with non-metastatic breast cancer

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