A Tailored Web-Based Psychoeducational Intervention for Cancer Patients and Their Family Caregivers

Abstract

Background Most programs addressing psychosocial concerns of cancer survivors are in-person programs that are expensive to deliver, have limited availability, and seldom deal with caregivers’ concerns. Objective This study examined the feasibility of translating an efficacious nurse-delivered program (FOCUS Program) for patients and their caregivers to a tailored, dyadic web-based format. Specific aims were to: (i) test the preliminary effects of the web-based intervention on patient and caregiver outcomes, (ii) examine participants’ program satisfaction, and (iii) determine the feasibility of using a web-based delivery format. Intervention/Methods A Phase II feasibility study was conducted with cancer patients (lung, breast, colorectal, prostate) and their family caregivers (N=38 dyads). The web-based intervention provided information and support tailored to the unique characteristics of each patient, caregiver, and their dyadic relationship. Primary outcomes were emotional distress and quality of life (QOL). Secondary outcomes were benefits of illness/caregiving, communication, support, and self-efficacy. Analyses included descriptive statistics and repeated measures ANOVA. Results Dyads had a significant decrease in emotional distress, increase in QOL, and perceived more benefits of illness/caregiving. Caregivers also had significant improvement in self-efficacy. There were no changes in communication. Participants were satisfied with program usability, but recommended additional content. Conclusions It was possible to translate a clinician-delivered program to a web-based format that was easy to use and had positive effects on dyadic outcomes. Implications for Practice The web-based program is a promising way to provide psychosocial care to more patients and caregivers using fewer personnel. It needs further testing in a larger RCT.

Telemedicine Use Among Caregivers of Cancer Patients: Systematic Review (Preprint)

“…Five studies reported significant differences in Quality of Life aspects: three of them showed significant effects in all dimensions of Quality of Life [52,65,67]; Two studies showed significant effects in spiritual and social well-being [59,65], while one study [60] showed significant outcomes in social well-being. Emotional distress or stress symptoms revealed significant differences between pre-and post-treatment in five of the considered studies [50,52,65,67,69], while both depressive symptoms [55,57,65] and perceived social support [62,65,66] improved in three different trials. Furthermore, included articles reported significant effects -albeit smaller -in other measured outcomes: after the completion of the interventions, family members also experienced less anxiety, less sense of disruptiveness, hopelessness and uncertainty, less burden, and negative appraisal of caregiving.…”

“…These improved outcomes were: caregiver self-efficacy, Quality of Life, distress, depression, appraisal of caregiving, and perceived social support. Caregiver self-efficacy both in managing own emotions and in helping the patients to control symptoms was measured in five studies [52,59,61,67,70] and was always statistically significant. Five studies reported significant differences in Quality of Life aspects: three of them showed significant effects in all dimensions of Quality of Life [52,65,67]; Two studies showed significant effects in spiritual and social well-being [59,65], while one study [60] showed significant outcomes in social well-being.…”

“…Caregiver self-efficacy both in managing own emotions and in helping the patients to control symptoms was measured in five studies [52,59,61,67,70] and was always statistically significant. Five studies reported significant differences in Quality of Life aspects: three of them showed significant effects in all dimensions of Quality of Life [52,65,67]; Two studies showed significant effects in spiritual and social well-being [59,65], while one study [60] showed significant outcomes in social well-being. Emotional distress or stress symptoms revealed significant differences between pre-and post-treatment in five of the considered studies [50,52,65,67,69], while both depressive symptoms [55,57,65] and perceived social support [62,65,66] improved in three different trials.…”

“…relationship with partner, perception of patient's health condition). In the former, the most examined constructs are Quality of Life [50,52,54,56,59,62,[64][65][66][67], and Distress [50,52,53,59,61,62,65,[67][68][69]. To assess Quality of Life different tools were used including the Functional Assessment of Cancer Treatment (FACT-G) (n = 4), the Short Form (SF) 36-item and 12-item version (n = 2), the CG QOL Scale-Cancer (CQOL-C) (n = 2), the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) (n = 1), the Medical Outcomes Study 12-item short form (MOS SF-12) (n = 1), the UCLA Prostate Cancer Index (n=1).…”

“…In twelve papers an intervention was developed an intervention for a unique type of cancer patients [49,[51][52][53][54]58,60,61,65,66,68,70], while the others implemented telemedicine tools for a multifaceted sample including patients with different cancer diagnoses [48,50,[55][56][57]59,[62][63][64]67,71].…”