Development and pilot testing of an online intervention to support young couples' coping and adjustment to breast cancer

Abstract

Couplelinks is an original, professionally facilitated online intervention tailored to the unique challenges facing young women with breast cancer and their male partners. The purpose of this evaluation was to determine the feasibility and acceptability of the intervention and areas for improvement. Sixteen couples were sequentially enrolled over an 18-month period. Couples provided feedback via a treatment satisfaction survey, and post-treatment interviews with a sub-group of participants. Qualitative information was analysed for themes relevant to the program's acceptability, perceived benefits and limitations, and directions for improvement. Of the 16 couples who enrolled, six completed four modules or less, and 10 completed the entire program. Completers reported satisfaction with the program overall, as well as with the website useability and professional facilitation. Reported benefits were: enhanced communication and self-other knowledge; creation of opportunities for meaningful, cancer-related discussion; affirmation of relationship strengths; and a greater sense of closeness between partners. The main reported limitation was how program participation disrupted the couple's usual routine. Themes related to non-completion suggest that partners with particularly elevated relational or illness-related distress, or with differential levels of motivation, are less likely to finish. These findings have led to targeted improvements to the website and intervention protocol.

Cancer Survivors’ Experience With Telehealth: A Systematic Review and Thematic Synthesis

“…Of the total studies, 4 included only female survivors, [30-33], 1 study included only men [34], while the remaining 17 included both male and female participants [35-51]. Only 4 studies reported on the ethnicity of their participants [33,38,47,48]. Survivor cancer diagnoses included breast, lung, colorectal, ovarian, head and neck, prostate, hematological disease, and lymphoma.…”

“…The media used within telehealth interventions were heterogeneous: 11 studies appraised telephone-based interventions, [30-32,34,35,42,43,47,49-51], 5 studies related to primarily Web-based interventions, [33,36,39,40,48], 1 study evaluated email communication [37], and 5 looked at interventions using handheld monitoring devices [38,41,44-46]. The purpose of the interventions was diverse and included: 15 which supported patients through treatment; 6 which monitored symptoms [36,38,41,44-46]; and 9 which provided psychological support, information, advice or self-management strategies [33-35,39,40,42,43,47,49]. For 2 studies, telehealth acted as a form of communication between patients and HCPs at various stages of their journey [37,48] and 5 interventions replaced clinic visits for follow-up patients [30-32,50,51].…”

“…Regarding the aims of the 22 studies, 9 explored the views of patients and health care professionals as to the use of telehealth [30,41,44-48,50,51], 9 the experience of only patients [31,32,34-36,38,40,42,43], and 4 the experience of both patients and family members [33,37,39,49]. For 11 studies, the primary aim was to test the acceptability and feasibility of telehealth interventions [33-35,38,41-45,47,48]: 8 focused primarily on the experience of intervention use [30-32,40,46,49-51], and 3 aimed to explore the potential benefits of telehealth [36,37,39].…”

“…For 11 studies, the primary aim was to test the acceptability and feasibility of telehealth interventions [33-35,38,41-45,47,48]: 8 focused primarily on the experience of intervention use [30-32,40,46,49-51], and 3 aimed to explore the potential benefits of telehealth [36,37,39]. Of the 22 studies, 8 were qualitative studies nested within larger trials of telehealth interventions [30,34,38,40,46,47,49,51].…”

“…This level of convenience was highlighted as especially important for those with caring and work responsibilities [30,31,50]. Web-based or email-based interventions were viewed as flexible as they could be easily logged into at any time, meaning survivors could make contact or complete activities when it suited them and fitted into their lives [33,36,37,39,40,46]. Telehealth interventions were easily integrated into daily routines.…”