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Fleszar-Pavlovic SE, Esquives BN, Brito AE, Sia AM, Kauffman MA, Lopes M, Moreno PI, Koru-Sengul T, Gong R, Wang T, Wieder ED, Rueda-Lara M, Antoni M, Komanduri K, Lesiuk T, Penedo FJ. eHealth mindfulness-based music therapy for patients undergoing allogeneic hematopoietic stem cell transplantation: A pilot randomized controlled trial protocol. Contemp Clin Trials 2024; 142:107577. [PMID: 38763308 DOI: 10.1016/j.cct.2024.107577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/12/2024] [Accepted: 05/16/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Allogeneic stem cell transplantation (allo-SCT) is the preferred therapy for patients with high-risk or relapsed hematologic malignancies, but may be complicated by psychological distress (e.g., depression, anxiety) and symptom burden (e.g., fatigue, pain). Mindfulness-based music therapy (MBMT), a relatively novel integrative medicine intervention that draws from mindfulness and music therapy principles, has shown promise in improving psychosocial outcomes and symptom burden in cancer patients. We outline an eHealth-based MBMT (eMBMT) intervention protocol examining: (1) feasibility, acceptability, and intended effects of eMBMT in improving HRQOL, symptom burden, and clinical markers of disease activity (e.g., infections), and (2) the extent to which eMBMT music therapy component-associated improvements in HRQOL, symptom burden, and disease activity are mediated by improvements in psychosocial and physiological (e.g., systemic inflammation, immune recovery) adaptation. METHODS Participants (n = 60) with a hematologic malignancy undergoing allo-SCT will be randomized to receive eMBMT or an eHealth-based mindfulness meditation (eMM) intervention. eMBMT includes eight 60-min sessions facilitated by a music therapist focusing on mindfulness and music therapy. eMM includes eight 60-min self-led MM practices. RESULTS Feasibility, acceptability, HRQOL, symptom burden, disease activity, and mediation effects of psychosocial and physiological adaptation will be assessed at baseline, pre-infusion, and post-engraftment with blood collection at baseline and post-engraftment. CONCLUSION The current pilot RCT is the first eMBMT intervention to address the HRQOL and symptom burden of patients who are undergoing allo-SCT. Results will inform a fully powered RCT to establish preliminary efficacy of eMBMT on improvements in HRQOL, symptom burden, and disease activity.
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Affiliation(s)
- Sara E Fleszar-Pavlovic
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Blanca Noriega Esquives
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Arianna E Brito
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Ann Marie Sia
- Department of Undergraduate Research, University of Miami, Coral Gables, FL, USA.
| | - Mary Adelyn Kauffman
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Maria Lopes
- Department of Psychology, College of Arts and Sciences, University of Miami, Coral Gables, FL, USA.
| | - Patricia I Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Rui Gong
- Department of Medicine and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Trent Wang
- Department of Medicine and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Eric D Wieder
- Department of Medicine and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Maria Rueda-Lara
- Department of Psychiatry and Behavioral Sciences and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Michael Antoni
- Department of Psychology and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Krishna Komanduri
- Department of Medicine, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
| | - Teresa Lesiuk
- Frost School of Music and Sylvester Comprehensive Cancer Center, University of Miami, Coral Gables, FL, USA.
| | - Frank J Penedo
- Departments of Psychology and Medicine, and Sylvester Comprehensive Cancer Center, University of Miami, Coral Gables, FL, USA.
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Vardar O, Serçekuş P. The effect of a mobile application for patients living with gynaecological cancer on their physical and psychosocial adaptation. Int J Palliat Nurs 2024; 30:128-137. [PMID: 38517850 DOI: 10.12968/ijpn.2024.30.3.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
BACKGROUND Education of patients with cancer and patient self-management allow better clinical outcomes using e-health or mobile health applications. AIMS To develop a mobile application to increase the physical and psychosocial adaptation for patients with gynecological cancer who are receiving chemotherapy and to investigate the effectiveness of the mobile application. METHODS This study was planned as a parallel, single-blind, pre-post test randomised controlled experimental study in which two groups (intervention-control) will be compared. A total of 52 gynecological cancer patients were planned to be included in the study. FINDINGS This study is in the protocol stage. Therefore, the results of the study have not yet been reported. CONCLUSIONS Evidence-based information within JineOnkolojik Destek provides rich data on coping with chemotherapy. In addition, the visual and auditory elements, real patient stories and videos, and the ability to ask questions and receive counselling from the research team can positively affect the physical and psychosocial health of the cancer survivors.
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Affiliation(s)
- Okan Vardar
- Lecturer, Faculty of Health Sciences, Pamukkale University, Türkiye
| | - Pınar Serçekuş
- Professor, Faculty of Health Sciences, Pamukkale University, Türkiye
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Zhang Y, Flannery M, Zhang Z, Underhill-Blazey M, Bobry M, Leblanc N, Rodriguez D, Zhang C. Digital Health Psychosocial Intervention in Adult Patients With Cancer and Their Families: Systematic Review and Meta-Analysis. JMIR Cancer 2024; 10:e46116. [PMID: 38315546 PMCID: PMC10877499 DOI: 10.2196/46116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 11/13/2023] [Accepted: 12/06/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Patients with cancer and their families often experience significant distress and deterioration in their quality of life. Psychosocial interventions were used to address patients' and families' psychosocial needs. Digital technology is increasingly being used to deliver psychosocial interventions to patients with cancer and their families. OBJECTIVE A systematic review and meta-analysis were conducted to review the characteristics and effectiveness of digital health interventions on psychosocial outcomes in adult patients with cancer and their family members. METHODS Databases (PubMed, Cochrane Library, Web of Science, Embase, CINAHL, PsycINFO, ProQuest Dissertations and Theses Global, and ClinicalTrials.gov) were searched for randomized controlled trials (RCTs) or quasi-experimental studies that tested the effects of a digital intervention on psychosocial outcomes. The Joanna Briggs Institute's critical appraisal checklists for RCTs and quasi-experimental studies were used to assess quality. Standardized mean differences (ie, Hedges g) were calculated to compare intervention effectiveness. Subgroup analysis was planned to examine the effect of delivery mode, duration of the intervention, type of control, and dosage on outcomes using a random-effects modeling approach. RESULTS A total of 65 studies involving 10,361 patients (mean 159, SD 166; range 9-803 patients per study) and 1045 caregivers or partners (mean 16, SD 54; range 9-244 caregivers or partners per study) were included in the systematic review. Of these, 32 studies were included in a meta-analysis of the effects of digital health interventions on quality of life, anxiety, depression, distress, and self-efficacy. Overall, the RCT studies' general quality was mixed (applicable scores: mean 0.61, SD 0.12; range 0.38-0.91). Quasi-experimental studies were generally of moderate to high quality (applicable scores: mean 0.75, SD 0.08; range 0.63-0.89). Psychoeducation and cognitive-behavioral strategies were commonly used. More than half (n=38, 59%) did not identify a conceptual or theoretical framework. Most interventions were delivered through the internet (n=40, 62%). The median number of intervention sessions was 6 (range 1-56). The frequency of the intervention was highly variable, with self-paced (n=26, 40%) being the most common. The median duration was 8 weeks. The meta-analysis results showed that digital psychosocial interventions were effective in improving patients' quality of life with a small effect size (Hedges g=0.05, 95% CI -0.01 to 0.10; I2=42.7%; P=.01). The interventions effectively reduced anxiety and depression symptoms in patients, as shown by moderate effect sizes on Hospital Anxiety and Depression Scale total scores (Hedges g=-0.72, 95% CI -1.89 to 0.46; I2=97.6%; P<.001). CONCLUSIONS This study demonstrated the effectiveness of digital health interventions on quality of life, anxiety, and depression in patients. Future research with a clear description of the methodology to enhance the ability to perform meta-analysis is needed. Moreover, this study provides preliminary evidence to support the integration of existing digital health psychosocial interventions in clinical practice. TRIAL REGISTRATION PROSPERO CRD42020189698; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=189698.
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Affiliation(s)
- Yingzi Zhang
- Magnet Program and Nursing Research Department, UT Southwestern Medical Center, Dallas, TX, United States
| | - Marie Flannery
- School of Nursing, University of Rochester Medical Center, Rochester, NY, United States
| | - Zhihong Zhang
- School of Nursing, University of Rochester Medical Center, Rochester, NY, United States
| | | | - Melanie Bobry
- School of Nursing, University of Rochester Medical Center, Rochester, NY, United States
| | - Natalie Leblanc
- School of Nursing, University of Rochester Medical Center, Rochester, NY, United States
| | - Darcey Rodriguez
- Edward G Miner Library, University of Rochester Medical Center, Rochester, NY, United States
| | - Chen Zhang
- School of Nursing, University of Rochester Medical Center, Rochester, NY, United States
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Vaagan A, Haaland-Øverby M, Eriksen AA, Fredriksen K, Stenov V, Varsi C, Ingadóttir B, Cleal BR, Alvheim AR, Westermann KF, Strømme H, Kristjansdottir OB. Group-based patient education via videoconference: A scoping review. PATIENT EDUCATION AND COUNSELING 2024; 118:108026. [PMID: 37939596 DOI: 10.1016/j.pec.2023.108026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/12/2023] [Accepted: 10/15/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To summarize recent evidence on the feasibility, acceptability, and effectiveness of videoconference (VC) group-based patient and caregiver education. METHODS Systematic searches of the literature were conducted. Data was extracted on the characteristics of the studies and interventions and on the feasibility, acceptability, and effectiveness of the interventions. RESULTS From 12,570 hits, 65 studies were eligible for inclusion. Their results confirmed previously identified tendencies of high feasibility and acceptability of VC group patient education, and improved health outcomes. However, evidence of effectiveness is limited, and the quality of studies is varied. Several patient and caregiver groups also remain under-researched. Only four studies stated that facilitators were trained in using VC-technology. CONCLUSION VC group-based patient and caregiver education is feasible and acceptable and may improve health outcomes for participant patients and caregivers. However future research should increase the number of high-quality randomized controlled trials to establish the effectiveness of VC group-based education for several groups of patients and caregivers. Studies of the training of facilitators is also warranted. PRACTICE IMPLICATIONS The results suggest that interventions should be more accessible. An overview of the recent evidence may also stimulate the development and evaluation of VC group-based patient and caregiver education.
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Affiliation(s)
- André Vaagan
- Norwegian National Advisory Unit on Learning and Mastery in Health, Postbox 4959 Nydalen, 0424 Oslo, Norway.
| | - Mette Haaland-Øverby
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway; Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Kari Fredriksen
- Learning and Mastery Center, Stavanger University Hospital, Stavanger, Norway
| | - Vibeke Stenov
- Health Promotion Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Cecilie Varsi
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway,; Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Brynja Ingadóttir
- Faculty of Nursing and Midwifery, University of Iceland, Reykjavik, Iceland
| | - Bryan Richard Cleal
- Health Promotion Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Anita Røyneberg Alvheim
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Karl Fredrik Westermann
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Hilde Strømme
- Library of Medicine and Science, University of Oslo, Oslo, Norway
| | - Olöf Birna Kristjansdottir
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway; Mental health team West, Primary care of the capital area, Reykjavik, Iceland
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Lin H, Ye M, Lin Y, Chen F, Chan S, Cai H, Zhu J. Mobile App for Gynecologic Cancer Support for Patients With Gynecologic Cancer Receiving Chemotherapy in China: Multicenter Randomized Controlled Trial. J Med Internet Res 2023; 25:e49939. [PMID: 37955943 PMCID: PMC10682921 DOI: 10.2196/49939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/01/2023] [Accepted: 10/24/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Patients with gynecologic cancer receiving chemotherapy often report unmet supportive care needs. Compared with traditional face-to-face clinical interventions, mobile health can increase access to supportive care and may address patients' needs. Although app-based support programs have been developed to support patients with gynecologic cancer, their efficacy has not been adequately tested. OBJECTIVE The aim of this study was to examine the efficacy of a mobile app for gynecologic cancer support (MGCS) for patients with gynecologic cancer receiving chemotherapy in China. METHODS A multicenter randomized controlled trial was conducted in 2 university-affiliated hospitals in China. A total of 168 Chinese patients with gynecologic cancer were recruited and randomized to receive routine care or MGCS program plus routine care for 24 weeks. The Mishel uncertainty in illness theory guided the development of MGCS program, which has 4 modules: weekly topics, emotional care, discussion center, and health consultation. The primary outcome of this program was the assessment of the uncertainty in illness. The secondary outcomes were quality of life, symptom distress, and social support. All health outcomes were evaluated at baseline (T0), 12 weeks (T1), and 24 weeks (T2). Repeated measures analysis of covariance was used to assess the efficacy of the MGCS program. RESULTS In this trial, 67 patients in the control group and 69 patients in the intervention group completed 2 follow-up assessments (response rate, 136/168, 81%). At 12 weeks, no significant differences were observed in any of the health outcomes between the 2 groups. At 24 weeks, compared to patients in the control group, those in the intervention group reported significant decreased uncertainty in illness (P<.001; d=-0.60; adjusted mean difference -7.69, 95% CI -11.31 to -4.07) and improved quality of life (P=.04; d=0.30; adjusted mean difference 4.77, 95% CI 0.12-9.41). CONCLUSIONS The MGCS program demonstrated efficacy in supporting patients with gynecologic cancer receiving chemotherapy. This trial illustrates that an app-based program can be incorporated into routine care to support patients with cancer and suggests that allocation of more resources (grants, manpower, etc) to mobile health in clinics is warranted. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000033678; https://www.chictr.org.cn/showproj.html?proj=54807.
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Affiliation(s)
- Huicong Lin
- School of Medicine, Xiamen University, Xiamen, Fujian Province, China
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
| | - Mingzhu Ye
- Department of Gynecology and Obstetrics, Zhongshan Hospital, Xiamen University, Xiamen, Fujian Province, China
| | - Yanjuan Lin
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - Fuhong Chen
- Department of Nursing, First Affiliated Hospital, Xiamen University, Xiamen, Fujian Province, China
| | - Sally Chan
- President Office, Tung Wah College, Hongkong, China
| | - Hongxia Cai
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xiamen University, Xiamen, Fujian Province, China
| | - Jiemin Zhu
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
- Cancer Care Research Unit, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia
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Kern D, Ljótsson B, Lönndahl L, Hedman-Lagerlöf E, Bradley M, Lindefors N, Kraepelien M. A Digital Self-help Intervention for Atopic Dermatitis: Analysis of Secondary Outcomes From a Feasibility Study. JMIR DERMATOLOGY 2023; 6:e42360. [PMID: 37632924 PMCID: PMC10335136 DOI: 10.2196/42360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 03/22/2023] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is a common inflammatory skin disease characterized by dry skin, eczematous lesions, and an often severe pruritus. The disease may have a negative effect on quality of life and is also associated with symptoms of anxiety and depression. Few individuals with AD receive any form of behavioral intervention. Behavioral interventions for AD are potentially efficacious but need to be constructed so that they are safe, credible, and user-friendly. We have previously reported on a feasibility study that demonstrated that a self-management version of a digital intervention based on cognitive behavioral therapy (CBT) for AD can potentially be effective in reducing AD symptoms. The aim of this secondary report was to further examine treatment feasibility and preliminary effects on dermatological quality of life, itching sensations, depressive symptoms, and perceived stress. OBJECTIVE This is a secondary report on intervention credibility, usability, adverse events, and preliminary effects on secondary measures of a self-management digital intervention for atopic dermatitis. METHODS In total, 21 adults with AD, recruited nationwide in Sweden, were assessed by telephone, and used the digital intervention for 8 weeks. Participants were also assessed directly afterward and 3 months after the end of the intervention. There was no therapist guidance. Feasibility indicators included intervention credibility, usability, and possible adverse effects. Other measures included preliminary effects on dermatological quality of life, itching sensations, depressive symptoms, and perceived stress. RESULTS The intervention was regarded as credible and no serious adverse events were reported. System usability was, however, found to be below the predetermined cutoff for acceptable usability. Preliminary effects at 3-month follow-up were in the moderate to large range for dermatological quality of life (Cohen d=0.89, 95% CI 0.18-1.56), itching sensations (Cohen d=0.85, 95% CI 0.15-1.52), depressive symptoms (Cohen d=0.78, 95% CI 0.1-1.45), and perceived stress (Cohen d=0.75, 95% CI 0.01-1.36). CONCLUSIONS This 8-week self-management digital CBT-based intervention was, together with telephone calls before and after, a feasible intervention for participants with AD. Preliminary effects were promising and should be explored further in a randomized controlled trial. Intervention usability was, however, rated below cutoff scores. Efforts should be made to improve written material to increase usability.
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Affiliation(s)
- Dorian Kern
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Brjánn Ljótsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Louise Lönndahl
- Dermatology and Venereology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Erik Hedman-Lagerlöf
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maria Bradley
- Dermatology and Venereology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Nils Lindefors
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Martin Kraepelien
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Cyr MP, Dostie R, Camden C, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand MH, Morin M. Acceptability of multimodal pelvic floor physical therapy to treat dyspareunia after gynecological malignancies: a qualitative study of women's views and experiences. Int Urogynecol J 2022; 34:1061-1073. [PMID: 35947187 PMCID: PMC9364276 DOI: 10.1007/s00192-022-05304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/04/2022] [Indexed: 11/28/2022]
Abstract
Introduction and hypothesis Multimodal pelvic floor physical therapy (PFPT) is recommended after gynecological malignancies to treat dyspareunia. However, data to strongly support its implementation in the cancer care continuum are lacking. The aim of this study was to explore the views and experiences of gynecological cancer survivors with dyspareunia regarding the acceptability of multimodal PFPT. Methods This qualitative study was conducted with the participants (n = 28) of a study investigating a 12-week multimodal PFPT treatment. Individual semi-structured telephone interviews served to collect qualitative data pertaining to women’s views and experiences of the treatment they received. Interviews were recorded and transcribed for analysis using the interpretative description framework. Results Our cohort described the appropriateness of the treatment in terms of modalities, physical therapist, care delivery, and intensity (Theme 1). While the intensity was reported as demanding by a few, all participants stressed that it was relevant to see significant improvements (Theme 2). In addition to the treatment characteristics and women’s beliefs and attitudes, noticing the treatment effects motivated their participation (Theme 2). Women expressed being highly satisfied with the treatment based on their positive experiences and the balance between their efforts and the results they obtained (Theme 3). As a result, they all recommended this treatment (Theme 3). Conclusions This is the first study to examine the acceptability of multimodal PFPT in the context of gynecological malignancies. This treatment was found acceptable and can be offered to gynecological cancer survivors. Supplementary Information The online version contains supplementary material available at 10.1007/s00192-022-05304-4.
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Affiliation(s)
- Marie-Pierre Cyr
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada.,Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada.,School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, 84a Services Road, St Lucia, Brisbane, Queensland, 4072, Australia
| | - Rosalie Dostie
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada.,Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada
| | - Chantal Camden
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada.,Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada
| | - Chantale Dumoulin
- School of Rehabilitation, Faculty of Medicine, University of Montreal, 7077 Park Avenue, Montreal, Quebec, H3N 1X7, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary, Montreal, Quebec, H3W 1W6, Canada
| | - Paul Bessette
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada.,Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Annick Pina
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, University of Montreal, PO Box 6128, Centre-ville Station, Montreal, Quebec, H3C 3J7, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, 900 St Denis St, Montreal, Quebec, H2X 0A9, Canada
| | - Walter Henry Gotlieb
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, McGill University, 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada.,Lady Davis Institute of the Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, H3T 1E2, Canada
| | - Korine Lapointe-Milot
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada.,Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Marie-Hélène Mayrand
- Research Center of the Centre Hospitalier de l'Université de Montréal, 900 St Denis St, Montreal, Quebec, H2X 0A9, Canada.,Departments of Obstetrics and Gynecology and Social and Preventive Medicine, Faculty of Medicine, University of Montreal, PO Box 6128, Centre-ville Station, Montreal, Quebec, H3C 3J7, Canada
| | - Mélanie Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada. .,Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada.
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Bäuerle A, Martus P, Erim Y, Schug C, Heinen J, Krakowczyk JB, Steinbach J, Damerau M, Bethge W, Dinkel A, Dries S, Mehnert-Theuerkauf A, Neumann A, Schadendorf D, Tewes M, Wiltink J, Wünsch A, Zipfel S, Graf J, Teufel M. Web-based mindfulness and skills-based distress reduction for patients with cancer: study protocol of the multicentre, randomised, controlled confirmatory intervention trial Reduct. BMJ Open 2022; 12:e056973. [PMID: 35649607 PMCID: PMC9161102 DOI: 10.1136/bmjopen-2021-056973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Many patients with cancer experience severe psychological distress, but as a result of various barriers, few of them receive psycho-oncological support. E-mental health interventions try to overcome some of these barriers and the limitation of healthcare offers, enabling patients with cancer to better cope with psychological distress. In the proposed trial, we aim to assess the efficacy and cost-effectiveness of the manualised e-mental health intervention Make It Training- Mindfulness-Based and Skills-Based Distress Reduction in Oncology. Make It Training is a self-guided and web-based psycho-oncological intervention, which includes elements of cognitive behavioural therapy, mindfulness-based stress reduction and acceptance and commitment therapy. The training supports the patients over a period of 4 months. We expect the Make It Training to be superior to treatment as usual optimised (TAU-O) in terms of reducing distress after completing the intervention (T1, primary endpoint). METHODS AND ANALYSIS The study comprises a multicentre, prospective, randomised controlled confirmatory interventional trial with two parallel arms. The proposed trial incorporates four distinct measurement time points: the baseline assessment before randomisation, a post-treatment assessment and 3 and 6 month follow-up assessments. We will include patients who have received a cancer diagnosis in the past 12 months, are in a curative treatment setting, are 18-65 years old, have given informed consent and experience high perceived psychological distress (Hospital Anxiety and Depression Scale ≥13) for at least 1 week. Patients will be randomised into two groups (Make It vs TAU-O). The aim is to allocate 600 patients with cancer and include 556 into the intention to treat analysis. The primary endpoint, distress, will be analysed using a baseline-adjusted ANCOVA for distress measurement once the intervention (T1) has been completed, with study arm as a binary factor, baseline as continuous measurement and study centre as an additional categorical covariate. ETHICS AND DISSEMINATION The Ethics Committee of the Medical Faculty Essen has approved the study (21-10076-BO). Results will be published in peer-reviewed journals, conference presentations, the project website, and among self-help organisations. TRIAL REGISTRATION NUMBER German Clinical Trial Register (DRKS); DRKS-ID: DRKS00025213.
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Affiliation(s)
- Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Essen, Essen, Germany
| | - Peter Martus
- Institute of Clinical Epidemiology and Applied Biostatistics, Eberhard Karls University Tübingen, University Hospital Tübingen, Tübingen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Jana Heinen
- Department of Psychosomatic Medicine and Psychotherapy, Eberhard Karls University, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Tübingen, Tübingen-Stuttgart, Germany
| | - Julia Barbara Krakowczyk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Essen, Essen, Germany
| | - Jasmin Steinbach
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Essen, Essen, Germany
| | - Mirjam Damerau
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Essen, Essen, Germany
| | - Wolfgang Bethge
- Centre of Clinical Trials (ZKS) Tübingen, Eberhard Karls University Tübingen, University Hospital Tübingen, Tübingen, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, München, Germany
| | - Sebastian Dries
- Healthcare Department, Fraunhofer Institute for Software and Systems Engineering (ISST), Dortmund, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Neumann
- Institute of Health Care Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Dirk Schadendorf
- Comprehensive Cancer Center (CCC), University Hospital Essen, Essen, Germany
- Department of Dermatology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Mitra Tewes
- Comprehensive Cancer Center (CCC), University Hospital Essen, Essen, Germany
- Department of Medical Oncology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander Wünsch
- Clinic for Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-Universität Freiburg, Freiburg Medical Center, Freiburg, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Eberhard Karls University, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Tübingen, Tübingen-Stuttgart, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, Eberhard Karls University, University Hospital Tübingen, Tübingen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Tübingen, Tübingen-Stuttgart, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center (CCC), University Hospital Essen, Essen, Germany
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Conduit C, Guo C, Smith AB, Rincones O, Baenziger O, Thomas B, Goad J, Lenaghan D, Lawrentschuk N, Wong LM, Corcoran NM, Ross M, Gibbs P, O'Haire S, Anton A, Liow E, Lewin J, Tran B. Distress in People with Newly Diagnosed Testicular Cancer – Role for an Online Intervention to Alleviate Distress? (Preprint). JMIR Cancer 2022; 8:e39725. [DOI: 10.2196/39725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/24/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
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Pereira DR, Silva ER, Carvalho-Maia C, Monteiro-Reis S, Lourenço C, Calisto R, Teixeira RJ, Carlson LE, Bart G, Vainio SJ, Sales MGF, Jerónimo C, Henrique R. The modulatory role of internet-supported mindfulness-based cognitive therapy on extracellular vesicles and psychological distress in people who have had cancer: a protocol for a two-armed randomized controlled study. Trials 2022; 23:118. [PMID: 35123569 PMCID: PMC8817152 DOI: 10.1186/s13063-022-06045-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/19/2022] [Indexed: 01/10/2023] Open
Abstract
Background Mindfulness-based interventions (MBIs) have been used in oncology contexts as a promising tool with numerous benefits for various health-related and psychosocial outcomes. Despite the increasing popularity of MBIs, few randomized controlled trials (RCTs) have examined their effects upon biological parameters. Specifically, no previous study has examined the effects of MBIs on extracellular vesicles (EVs), which are potentially important markers of health, disease, and stress. Moreover, the lack of RCTs is even more limited within the context of technology-mediated MBIs and long-term effects. Methods The current study protocol presents a two-arm, parallel, randomized controlled study investigating the effects of internet-supported mindfulness-based cognitive therapy (MBCT) compared with treatment as usual (TAU). Primary outcomes are psychological distress and EV cargo of distressed participants with previous breast, colorectal, or prostate cancer diagnoses. Secondary outcomes are self-reported psychosocial and health-related measures, and additional biological markers. Outcomes will be assessed at baseline, 4 weeks after baseline (mid-point of the intervention), 8 weeks after baseline (immediately post-intervention), 24 weeks after baseline (after booster sessions), and 52 weeks after baseline. Our goal is to recruit at least 111 participants who have been diagnosed with breast, prostate, or colorectal cancer (cancer stage I to III), are between 18 and 65 years old, and have had primary cancer treatments completed between 3 months and 5 years ago. Half of the participants will be randomized to the TAU group, and the other half will participate in an 8-week online MBCT intervention with weekly group sessions via videoconference. The intervention also includes asynchronous homework, an online retreat after the fifth week, and 4 monthly booster sessions after completion of the 8-week programme. Discussion This study will allow characterizing the effects of internet-based MBCT on psychosocial and biological indicators in the context of cancer. The effects on circulating EVs will also be investigated, as a possible neurobiological pathway underlying mind-body intervention effects. Trial registration ClinicalTrials.govNCT04727593 (date of registration: 27 January 2021; date of record verification: 6 October 2021). Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06045-x.
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Anisman H, Kusnecov AW. Adopting healthy behaviors: Toward prevention and cures. Cancer 2022. [DOI: 10.1016/b978-0-323-91904-3.00019-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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The efficacy of web or mobile-based interventions to alleviate emotional symptoms in people with advanced cancer: a systematic review and meta-analysis. Support Care Cancer 2021; 30:3029-3042. [PMID: 34735601 DOI: 10.1007/s00520-021-06496-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/09/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE This review aims to critically evaluate the efficacy of web or mobile-based (WMB) interventions impacting emotional symptoms in patients with advanced cancer. METHOD Articles published from 1991 to 2019 were identified using PubMed, PsycINFO, CINAHL, and Scopus. Only interventions involving adults with advanced cancer using a WMB intervention to manage emotional symptoms were included. Risk of bias was assessed using ROBINS-I and ROB2 tools. Studies that reported mean symptom scores were pooled using a random-effects model, and standardized mean difference (SMD) and 95% CIs were calculated. RESULTS Twenty-three of the 1177 screened studies met the inclusion criteria, and a total sample of 2558 patients were included. The sample was 57% female, and 33% had advanced cancer with mean age of 57.15 years. Thirteen studies evaluated anxiety, nineteen evaluated depression, and eleven evaluated distress. Intervention components included general information, tracking, communication, multimedia choice, interactive online activities, tailoring/feedback, symptom management support content, and self-monitoring. Overall pooled results showed that WMB interventions' effects on decreasing anxiety (SMD - 0.20, - 0.45 to 0.05, I2 = 72%), depression (SMD - 0.10, - 0.30 to 0.11, I2 = 73%), and distress (SMD - 0.20, - 0.47 to 0.06, I2 = 60%) were not significant for randomized controlled trials (RCTs). In contrast, WMB interventions significantly decreased symptoms of anxiety (p = .002) in a sub-group analysis of non-RCTs. CONCLUSION This meta-analysis demonstrated that WMB interventions were not efficacious in alleviating emotional symptoms in adults with advanced cancer. Considering the diversity of interventions, the efficacy of WMB interventions and its impacts on emotional symptoms should be further explored.
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Mathew A, Doorenbos AZ, Jang MK, Hershberger PE. Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model. J Cancer Surviv 2021; 15:427-451. [PMID: 32949353 PMCID: PMC10960234 DOI: 10.1007/s11764-020-00938-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/05/2020] [Indexed: 01/18/2023]
Abstract
PURPOSE People with cancer experience significant physical and psychological symptoms, during as well as after primary treatment. Acceptance and Commitment Therapy (ACT), a psychological intervention, reduces both types of symptoms among individuals with chronic pain and emotional distress. Due to the unique challenges of cancer survivorship, this systematic review critically evaluates and synthesizes the literature on the context, mechanisms, and effect of ACT among adult cancer survivors. METHODS Articles were retrieved from the CINAHL, MEDLINE via Ovid, Web of Science, PsycInfo, Scopus, Embase, Google Scholar, and Cochrane databases. Selected grey literature portals, clinical trial registries, and conference proceedings were also searched. The NIH tools were used to assess study quality and the revised Cochrane Risk-of-Bias tool to assess risk of bias RESULTS: Thirteen articles, reporting on 537 cancer survivors with various cancer types, were included. ACT significantly reduced anxiety, depression, and fear of cancer recurrence and improved psychological flexibility and quality of life. Outcomes such as pain and insomnia were understudied. Lack of participant blinding and non-random assignment were the most common methodological issues. A conceptual model is proposed that describes the possible influencing factors of an ACT-based intervention in cancer survivors. CONCLUSION Review findings suggest that ACT is an effective intervention to improve some of the common concerns among cancer survivors. While all the studies in the review were recent (published 2015-2019), they examined only a limited number of outcomes. Hence, more methodologically rigorous studies which examine the effect of ACT on other troubling symptoms among cancer survivors are warranted. IMPLICATIONS FOR CANCER SURVIVORS Incorporating ACT into comprehensive post-treatment survivorship care can enhance psychological flexibility and reduce anxiety, depression, and fear.
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Affiliation(s)
- Asha Mathew
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois, 845 S. Damen Ave. Room 1024, Chicago, IL, 60612, USA.
- College of Nursing, Christian Medical College, Vellore, India.
| | - Ardith Z Doorenbos
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois, 845 S. Damen Ave. Room 1024, Chicago, IL, 60612, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Min Kyeong Jang
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois, 845 S. Damen Ave. Room 1024, Chicago, IL, 60612, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Patricia E Hershberger
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois, 845 S. Damen Ave. Room 1024, Chicago, IL, 60612, USA
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Borghouts J, Eikey E, Mark G, De Leon C, Schueller SM, Schneider M, Stadnick N, Zheng K, Mukamel D, Sorkin DH. Barriers to and Facilitators of User Engagement With Digital Mental Health Interventions: Systematic Review. J Med Internet Res 2021; 23:e24387. [PMID: 33759801 PMCID: PMC8074985 DOI: 10.2196/24387] [Citation(s) in RCA: 240] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/24/2020] [Accepted: 02/08/2021] [Indexed: 01/14/2023] Open
Abstract
Background Digital mental health interventions (DMHIs), which deliver mental health support via technologies such as mobile apps, can increase access to mental health support, and many studies have demonstrated their effectiveness in improving symptoms. However, user engagement varies, with regard to a user’s uptake and sustained interactions with these interventions. Objective This systematic review aims to identify common barriers and facilitators that influence user engagement with DMHIs. Methods A systematic search was conducted in the SCOPUS, PubMed, PsycINFO, Web of Science, and Cochrane Library databases. Empirical studies that report qualitative and/or quantitative data were included. Results A total of 208 articles met the inclusion criteria. The included articles used a variety of methodologies, including interviews, surveys, focus groups, workshops, field studies, and analysis of user reviews. Factors extracted for coding were related to the end user, the program or content offered by the intervention, and the technology and implementation environment. Common barriers included severe mental health issues that hampered engagement, technical issues, and a lack of personalization. Common facilitators were social connectedness facilitated by the intervention, increased insight into health, and a feeling of being in control of one’s own health. Conclusions Although previous research suggests that DMHIs can be useful in supporting mental health, contextual factors are important determinants of whether users actually engage with these interventions. The factors identified in this review can provide guidance when evaluating DMHIs to help explain and understand user engagement and can inform the design and development of new digital interventions.
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Affiliation(s)
| | - Elizabeth Eikey
- University of California San Diego, San Diego, CA, United States
| | - Gloria Mark
- University of California Irvine, Irvine, CA, United States
| | | | | | | | - Nicole Stadnick
- University of California San Diego, San Diego, CA, United States
| | - Kai Zheng
- University of California Irvine, Irvine, CA, United States
| | - Dana Mukamel
- University of California Irvine, Irvine, CA, United States
| | - Dara H Sorkin
- University of California Irvine, Irvine, CA, United States
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15
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Matis J, Svetlak M, Slezackova A, Svoboda M, Šumec R. Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. J Med Internet Res 2020; 22:e20709. [PMID: 33196452 PMCID: PMC7704284 DOI: 10.2196/20709] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 01/07/2023] Open
Abstract
Background eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient. Objective This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition. Methods In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method. Results
A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group:
median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48;
between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face
MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer.
Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.
Conclusions Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.
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Affiliation(s)
- Juraj Matis
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic
| | - Miroslav Svetlak
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Alena Slezackova
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic.,Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marek Svoboda
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Rastislav Šumec
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic
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Penedo FJ, Oswald LB, Kronenfeld JP, Garcia SF, Cella D, Yanez B. The increasing value of eHealth in the delivery of patient-centred cancer care. Lancet Oncol 2020; 21:e240-e251. [PMID: 32359500 PMCID: PMC7643123 DOI: 10.1016/s1470-2045(20)30021-8] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/02/2020] [Accepted: 01/14/2020] [Indexed: 12/23/2022]
Abstract
The increasing use of eHealth has ushered in a new era of patient-centred cancer care that moves beyond the traditional in-person care model to real-time, dynamic, and technology-assisted assessments and interventions. eHealth has the potential to better the delivery of cancer care through improved patient-provider communication, enhanced symptom and toxicity assessment and management, and optimised patient engagement across the cancer care continuum. In this Review, we provide a brief, narrative appraisal of the peer reviewed literature over the past 10 years related to the uses of patient-centred eHealth to improve cancer care delivery. These uses include the addressal of symptom management, health-related quality of life, and other patient-reported outcomes across cancer care. In addition, we discuss the challenges of, and opportunities for, accessibility, scalability, and implementation of these technologies, important areas for further development, and future research directions.
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Affiliation(s)
- Frank J Penedo
- Department of Psychology, University of Miami, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
| | - Laura B Oswald
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Sofia F Garcia
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
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Glynn BA, Khoo EL, MacLeay HML, Duong A, Cantave R, Poulin PA. Exploring Cancer Patients' Experiences of an Online Mindfulness-Based Program: A Qualitative Investigation. Mindfulness (N Y) 2020; 11:1666-1677. [PMID: 32670431 PMCID: PMC7346987 DOI: 10.1007/s12671-020-01380-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective Chronic neuropathic pain (CNP) is a common condition cancer survivors experience. Mindfulness training may be one approach to address the psychosocial factors associated with CNP. The purpose of this study was to understand patients’ experiences in an 8-week online mindfulness-based program (MBP), including techniques and skills learned and applied, barriers to practice, and research experiences. Methods Nineteen participants who were part of a randomized controlled trial consented to participate in a telephone interview or submit written responses via email post-course. Interviews were transcribed and analyzed using the principles of Applied Thematic Analysis (ATA). Results Predominant themes identified in participant interviews included (1) common humanity, (2) convenience, (3) teacher resonance, (4) perceived relaxation and calm, (5) pain and stress management, (6) half-day session, and (7) mindful breathing. Participants also identified helpful strategies learned and implemented from the course, as well as barriers to practice, and key components of their experiences in a randomized controlled trial, including a sense of disconnection post-course and needing continued ongoing sessions, and the importance of the facilitators’ skills in creating a comfortable and supportive space. Conclusions An online group-based MBP may offer a more accessible resource and form of psychosocial intervention and support for cancer survivors living with CNP. Furthermore, the need and consideration for implementing ongoing group maintenance sessions to minimize participants’ feelings of disconnect and abandonment post-course and post-study are warranted in future MBP development.
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Affiliation(s)
- Brittany A Glynn
- The Ottawa Hospital Research Institute, The Ottawa Hospital - General, Smyth Road, Ottawa, ON K1H 8L6 Canada
| | - Eve-Ling Khoo
- The Ottawa Hospital Research Institute, The Ottawa Hospital - General, Smyth Road, Ottawa, ON K1H 8L6 Canada
| | - Hayley M L MacLeay
- The Ottawa Hospital Research Institute, The Ottawa Hospital - General, Smyth Road, Ottawa, ON K1H 8L6 Canada
| | - An Duong
- The Ottawa Hospital Research Institute, The Ottawa Hospital - General, Smyth Road, Ottawa, ON K1H 8L6 Canada
| | - Rosemee Cantave
- The Ottawa Hospital Research Institute, The Ottawa Hospital - General, Smyth Road, Ottawa, ON K1H 8L6 Canada
| | - Patricia A Poulin
- The Ottawa Hospital Research Institute, The Ottawa Hospital - General, Smyth Road, Ottawa, ON K1H 8L6 Canada
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The effectiveness of online interventions for patients with gynecological cancer: An integrative review. Gynecol Oncol 2020; 158:143-152. [PMID: 32340692 DOI: 10.1016/j.ygyno.2020.04.690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/16/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE With advantages of easy accessibility and various multimedia interactivity formats, online interventions have been developed to improve health outcomes for patients with a variety of gynecological cancers, but evidence regarding their effectiveness for such patients is not well-understood. This review aimed to synthesize study findings that were published in English or Chinese regarding the effectiveness of online interventions on the quality of life, symptom distress, social support, psychological distress, sexual well-being, and body image in patients with gynecological cancer. METHODS This integrative review adhered to five steps, including problem identification, literature search, quality appraisal, data analysis, and presentation. Ten electronic databases (MEDLINE, ScienceDirect, SpringerLink, PubMed, Wiley Online Journals, Web of Science, OVID, CINAHL Plus with Full Text, China National Knowledge Infrastructure, and Cochrane Library) were searched from the inception of each database to April 2019 in accordance with the rigid and explicit inclusion and exclusion criteria. Version 2018 of the Mixed Methods Appraisal Tool was used for the quality appraisal of the articles. RESULTS Out of 276 articles, 24 potentially eligible articles were initially identified. A manual search retrieved an additional eligible three articles. After nine articles were excluded, ten quantitative, six qualitative, and two mixed-methods articles were finally included. Online interventions improved quality of life and body images in patients with gynecological cancer, but there were inconclusive effects on symptom distress, social support, psychological distress, and sexual well-being. CONCLUSIONS Online interventions have been increasingly used as clinically promising interventions to promote health outcomes among patients with gynecological cancer. Studies with more rigorous designs and sufficient sample sizes are needed to elucidate the effectiveness of such online interventions. Healthcare workers can incorporate existing or new online interventions into their routine care to improve health outcomes for patients with gynecological cancer.
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Omidi Z, Kheirkhah M, Abolghasemi J, Haghighat S. Effect of lymphedema self-management group-based education compared with social network-based education on quality of life and fear of cancer recurrence in women with breast cancer: a randomized controlled clinical trial. Qual Life Res 2020; 29:1789-1800. [PMID: 32152817 PMCID: PMC7295820 DOI: 10.1007/s11136-020-02455-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality of life (QoL) of cancer survivors and can stimulate fear of cancer recurrence (FCR). Self-management education for lymphedema has been introduced as an effective method in controlling FCR. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients. METHODS This three-arm clinical trial studied 105 patients with breast cancer-related lymphedema referred to Seyed_Khandan rehabilitation center. Sampling was done by random allocation method in blocks of 3 with 35 subjects in each group. All subjects received routine lymphedema treatments. The group-based education (GE) and social network-based education (SNE) groups received self-management education in the clinic and Telegram™ messenger channel, respectively. Impairment in QoL and mean score of FCR were assessed before, immediately after, and three months after the intervention by using the Persian version of Lymphedema Life Impact Scale (LLIS) and Fear of Progression Questionnaire-Short Form (FoPQ-SF), respectively. Mixed-model ANOVA was applied for statistical analysis. RESULTS There was a significant time effect on total LLIS (P = 0.007), psychosocial (P = 0.038) and functional (P = 0.024) subscale changes in three groups of study. Interaction between the main effect of group and time on psychosocial subscale changes was statistically significant (P = 0.017). The multicomparison results illustrated that the main effect of time, the main effect of group, and interaction of them on the mean score of FCR were P = 0.084, P = 0.380, and P = 0.568, respectively. CONCLUSION Despite no significant reduction in the FCR score, results showed the improvement of most QoL aspects after three months of intervention. Although the social network-based education method was effective, the group-based education method was more beneficial. Applying these educational methods in lymphedema treatment protocols needs cost-effectiveness studies. TRIAL REGISTRATION This study was registered at the Iranian Registry of Clinical Trials (IRCT2017052834176N1).
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Affiliation(s)
- Zahra Omidi
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Masoomeh Kheirkhah
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Jamileh Abolghasemi
- Department of Biostatistics, School of Public Health, Iran University of Medical Science, Tehran, Iran
| | - Shahpar Haghighat
- Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.
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20
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Skrabal Ross X, Gunn KM, Olver I, Willems RA, Lechner L, Mesters I, Bolman CAW. Online psychosocial interventions for posttreatment cancer survivors: an international evidence review and update. Curr Opin Support Palliat Care 2020; 14:40-50. [PMID: 31789944 DOI: 10.1097/spc.0000000000000478] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW The present review describes recent research on online psychosocial interventions for posttreatment cancer survivors from January 2018 to June 2019. RECENT FINDINGS Twenty-three studies were included in the review (the majority included were feasibility studies and only five randomized controlled trials had large samples). Websites were the most common platforms for intervention delivery (9/23) and cognitive behavioral therapy was the most frequently used therapeutic approach (11/23). Three interventions based on this framework and delivered via websites or combined website-telehealth platforms showed to be effective in improving psychosocial issues (fear of cancer recurrence, insomnia, sleep quality, and prospective memory failures) in posttreatment cancer survivors. Web-based self-compassion writing was also found to be effective in addressing body image distress and body appreciation in breast cancer survivors. Feasibility studies mostly showed online interventions to be plausible and acceptable to cancer survivors. A good representation of online interventions for young adult cancer survivors (30%) was found. SUMMARY Online interventions show promise in addressing the psychosocial needs of cancer survivors. Despite new online interventions being found to be feasible and acceptable and some showing promise in addressing important psychosocial issues in cancer survivors posttreatment, more rigorous studies are required to inform supportive care for this population.
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Affiliation(s)
| | - Kate M Gunn
- Cancer Research Institute
- Department of Rural Health, University of South Australia
| | - Ian Olver
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Roy A Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen
| | - Ilse Mesters
- Faculty of Health, Medicine and Life Sciences, Department of Epidemiology, Research Institute CaPHRI, Maastricht University, Maastricht, the Netherlands
| | - Catherine A W Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen
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21
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Teoh D, Smith TJ, Song M, Spirtos NM. Care After Chemotherapy: Peripheral Neuropathy, Cannabis for Symptom Control, and Mindfulness. Am Soc Clin Oncol Educ Book 2018; 38:469-479. [PMID: 30231411 DOI: 10.1200/edbk_209437] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
As cancer therapies improve, patients are living longer. With these improvements in therapy comes a responsibility to optimize patients' quality of life during cancer therapy and beyond. This report reviews three timely and important topics. The first section reviews the mechanism underlying chemotherapy-induced peripheral neuropathy and evaluates the evidence for interventions to prevent and treat peripheral neuropathy. It also provides a framework for approaching the diagnosis and management of this common and bothersome side effect. The second section addresses the controversial but effective use of cannabinoids for cancer and chemotherapy symptoms. Although clinical trials are difficult to conduct because of the political and social stigma of this class of drugs, this review provides evidence of the efficacy of cannabinoids for treatment of pain and nausea. The last section addresses the mind-body connection, with a focus on the negative emotions patients with cancer often experience. This section assesses the literature regarding mindfulness-based programs to improve cancer-related stress. These three topics may appear unrelated, but all address one common goal: treating the body and the mind to optimize quality of life during and after cancer therapy.
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Affiliation(s)
- Deanna Teoh
- From the Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN; Division of Palliative Medicine, Johns Hopkins University, Baltimore, MD; Division of Oncology, Johns Hopkins University, Baltimore, MD; Division of Gynecologic Oncology, Women's Cancer Center of Nevada, Las Vegas, NV; The Apothecary Shoppe, Las Vegas, NV
| | - Thomas J Smith
- From the Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN; Division of Palliative Medicine, Johns Hopkins University, Baltimore, MD; Division of Oncology, Johns Hopkins University, Baltimore, MD; Division of Gynecologic Oncology, Women's Cancer Center of Nevada, Las Vegas, NV; The Apothecary Shoppe, Las Vegas, NV
| | - Mihae Song
- From the Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN; Division of Palliative Medicine, Johns Hopkins University, Baltimore, MD; Division of Oncology, Johns Hopkins University, Baltimore, MD; Division of Gynecologic Oncology, Women's Cancer Center of Nevada, Las Vegas, NV; The Apothecary Shoppe, Las Vegas, NV
| | - Nick M Spirtos
- From the Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN; Division of Palliative Medicine, Johns Hopkins University, Baltimore, MD; Division of Oncology, Johns Hopkins University, Baltimore, MD; Division of Gynecologic Oncology, Women's Cancer Center of Nevada, Las Vegas, NV; The Apothecary Shoppe, Las Vegas, NV
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22
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Printz C. Scientists probe link between stress and cancer: Studies show biological responses that appear to affect cancer growth. Cancer 2018; 124:2671-2672. [PMID: 29913050 DOI: 10.1002/cncr.31590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Gentry MT, Lapid MI, Clark MM, Rummans TA. Evidence for telehealth group-based treatment: A systematic review. J Telemed Telecare 2018; 25:327-342. [DOI: 10.1177/1357633x18775855] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Interest in the use of telehealth interventions to increase access to healthcare services is growing. Group-based interventions have the potential to increase patient access to highly needed services. The aim of this study was to systematically review the available literature on group-based video teleconference services. Methods The English-language literature was searched using Ovid MEDLINE, PubMed, PsycINFO and CINAHL for terms related to telehealth, group therapy and support groups. Abstracts were reviewed for relevance based on inclusion criteria. Multiple study types were reviewed, including open-label, qualitative and randomised controlled trial study designs. Data were compiled regarding participants, study intervention and outcomes. Specific areas of interest were the feasibility of and satisfaction with telehealth technology, as well as the effect of video teleconference delivery on group dynamics, including therapeutic alliance. Results Forty published studies met the inclusion criteria and were included in the review. Six were randomised controlled trials. Among the studies, there was a broad range of study designs, participants, group interventions and outcome measures. Video teleconference groups were found to be feasible and resulted in similar treatment outcomes to in-person groups. However, few studies were designed to demonstrate noninferiority of video teleconference groups compared with in-person groups. Studies that examined group process factors showed small decreases in therapeutic alliance in the video teleconference participants. Conclusions Video teleconference groups are feasible and produce outcomes similar to in-person treatment, with high participant satisfaction despite technical challenges. Additional research is needed to identify optimal methods of video teleconference group delivery to maximise clinical benefit and treatment outcomes.
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Affiliation(s)
| | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, USA
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