Long-term effectiveness and moderators of a web-based tailored intervention for cancer survivors on social and emotional functioning, depression, and fatigue: randomized controlled trial

Abstract

PurposeThe web-based computer-tailored Kanker Nazorg Wijzer (Cancer Aftercare Guide) supports cancer survivors with psychosocial issues during cancer recovery. The current study investigates whether the 6-month effects in increasing emotional and social functioning and reducing depression and fatigue hold at 12 months from baseline. Moreover, it explores whether patient characteristics moderate the 6- and 12-month intervention effectiveness.MethodsCancer survivors from 21 Dutch hospitals (November 2013–June 2014) were randomized to an intervention (n = 231) or a wait-list control group (n = 231). Intervention effects on emotional and social functioning (EORTC QLQ-C30), depression (HADS), and fatigue (CIS) were evaluated through multilevel linear regression analyses.ResultsAt 12 months from baseline, the intervention group no longer differed from the control group in emotional and social functioning, depression, and fatigue. Moderator analyses indicated that, at 6 months, the intervention was effective in improving social functioning for men (d = 0.34), reducing fatigue for participants ≤56 years (d = 0.44), and reducing depression for participants who received chemotherapy (d = 0.36). At 12 months, participants with a medium educational level reported higher social functioning (d = 0.19), while participants with a low educational level reported lower social functioning (d = 0.22) than participants with a similar educational level in the control group.ConclusionsThe intervention gave cancer patients a head start to psychological recovery after the end of cancer treatment. The control group caught up in the long run.Implications for cancer survivorsThe Cancer Aftercare Guide expedited recovery after cancer treatment. Being a low intensity, easy accessible, and relatively low cost intervention, it could serve as a relevant step in recovery and stepped care.Electronic supplementary materialThe online version of this article (doi:10.1007/s11764-017-0625-0) contains supplementary material, which is available to authorized users.

Interventions developed with the Intervention Mapping protocol in the field of cancer: A systematic review

“…Forty additional publications were retrieved reporting their needs assessment (n = 18), their step 4 (n = 3), their implementation planning (n = 1), their evaluation (n = 17), and their implementation (n = 1).…”

“…Forty additional publications were retrieved reporting their needs assessment [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] (n = 18), their step 4 [52][53][54] (n = 3), their implementation planning 55 (n = 1), their evaluation [56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] (n = 17), and their implementation 73 (n = 1).…”

Self‐management interventions for cancer survivors: A systematic review and evaluation of intervention content and theories

“…For some studies, we found multiple manuscripts associated with the same intervention 31,33,43,53,56,68 where separate outcomes [69][70][71] or long-term outcomes were reported. 69,70,[72][73][74][75][76][77] We combined these manuscripts as one study, using the author's name associated with the earliest publication date, and linked corresponding manuscripts by listing them under the related outcomes.…”

Psychological support for patients with cancer: evidence review and suggestions for future directions

“…[INSERT CBT is adaptable across clinical presentations and recently published trials include tailoring for: FCR [45*,51*]; clinically-elevated distress [40]; insomnia [36,39,40,44,48]; sexual dysfunction [43,55]; depression and/or anxiety [33,40,41**,47,50*]; fatigue [49]; symptom clusters [35,46]; hot flushes [34]; and broader non-specific psychosocial coping [53][54][55] Whilst this evidence is promising, much of it derives from trials under 'ideal' conditions. Few pragmatic trials have been conducted, and it remains unclear how well CBT works in 'real world' settings -for example, in patients with complex physical or psychological comorbidities.…”