Effectiveness of self-help workbook intervention on quality of life in cancer patients receiving chemotherapy: results of a randomized controlled trial

Abstract

Background A self-help workbook is expected to support cancer patients to cope with physical and psychosocial distress, to facilitate communication with medical staff, and to improve quality of life (QOL). We conducted a randomized controlled trial to evaluate the effectiveness of a self-help workbook intervention on QOL and survival. Methods From June 2014 to March 2015, patients with breast, colorectal, gastric, and lung cancer receiving outpatient chemotherapy were randomized into an intervention group (n = 100) or control group (n = 100). Intervention group participants received workbooks originally made for this study, read advice on how to cope with distress, and filled out questionnaires on the workbooks periodically. EORTC QLQ-C30 was evaluated at baseline, at 12 weeks, and at 24 weeks. The primary endpoint was Global Health Status / QOL scale (GQOL). Results No significant interaction was observed between the intervention and time in terms of GQOL or any of the functional scales. Among the 69 patients who continued cytotoxic chemotherapy at 24 weeks, the intervention was significantly associated with improved emotional functioning scores (P = 0.0007). Overall survival was not significantly different between the two groups. Conclusions Self-help workbook intervention was feasible in cancer patients receiving chemotherapy. Although the effect of the intervention was limited, a post-hoc subset analysis suggested that the intervention may improve emotional functioning among patients who receive long-term cytotoxic chemotherapy. Trial registration UMIN Clinical Trials Registry, UMIN000012842. Registered 14 January 2014.

Fatigue in breast cancer patients on chemotherapy: a cross-sectional study exploring clinical, biological, and genetic factors

“…Despite its burden and relatively high prevalence among breast cancer patients (ranging from 60 to 90%) [ 9 ], CRF remains underestimated and mistreated, and little is known about the underlying risk factors. Understanding the contributing factors would allow the implementation of adequate targeted interventions for better management and quality of care [ 2 , 7 , 10 ]. Several hypotheses have been suggested to identify the predisposing factors to higher sensitivity for tiredness, including neurobiological dysfunctions (alterations in the hypothalamic-pituitary-adrenal (HPA) axis [ 11 ] and the autonomic nervous system responsiveness [ 12 , 13 ]), pro-inflammatory cytokines and cellular immune system dysregulations [ 14 , 15 ], psychological disorders such as depression, anxiety, and sleep disorders [ 16 , 17 ], cancer treatments (e.g., regimen type, chemotherapy agents, doses) [ 18 ], in addition to other factors related to physical adaptability, pain [ 19 , 20 ], or genetic predisposition [ 21 – 23 ].…”

A pilot study of cognitive behavioural therapy integrated with activity pacing for fatigued breast cancer patients undergoing chemotherapy in Ethiopia

“…In this study, CBT-AP was found to be a feasible and potentially efficacious intervention for breast cancer patients undergoing chemotherapy. Another study conducted on cancer patients had shown that self-help workbook intervention was feasible in cancer patients receiving chemotherapy, although the effect of the intervention was limited ( 42 ). The discrepancy between the effects of intervention might be because the intervention was guided by a trained therapist in this study.…”

An exploratory cross-sectional study of the effects of ongoing relationships with accompanying patients on cancer care experience, self-efficacy, and psychological distress

“…To support cancer patients in coping with physical and psychological distress, Takano et al [ 9 ] developed a self-help workbook. The workbook is intended to improve communication with medical staff and improve quality of life.…”