Is the Wish to Participate in a Cancer Rehabilitation Program an Indicator of the Need? Comparisons of Participants and Non‐Participants in a Randomized Study

Abstract

SUMMARYIn parallel with a randomized study of the 'starting again' rehabilitation program for cancer patients, a group of 73 non-participants were monitored (another 20 patients declined monitoring). In comparison with participants (intervention + control), gender, diagnosis, and 10 out of 18 dependent measures differed significantly at baseline. The non-participants group included more men, mostly with cancer of the prostate and irrespective of gender, they showed lower problem levels than participants throughout. Thus, the wish to participate seems to be an indicator of the need for assistance in the rehabilitation process. Social validation of effects was performed by comparing the non-participants with the intervention group. The rationale for this comparison is that non-participants presumably felt so well that they were in no need of rehabilitation. Effects on three variables were socially validated: patients' appraisal of having received sufficient information, physical strength and fighting spirit. No negative effects on outcome variables resulting from being randomized to the control condition (resentful demoralization) were detected when non-participants were compared with controls over one year. Further analysis showed that although a few patients in the control group may have experienced resentful demoralization, this did not significantly affect the outcome variables.

Educational Support Programme for Gynaecological Cancer Patients and Their Families

“…Berglund et al and Berglund (7,19) report similar results and found in their studies of a rehabilitation programme for cancer patients that those who wanted to participate reported more problems at baseline than the controls.…”

Lessons to Be Learned From 25 Years of Research Investigating Psychosocial Interventions for Cancer Patients

“…This pattern suggested that the differences in psychological variables were the result of participants’ awareness of their group assignment and their expectations about it. Conversely, results from another randomized trial of a cancer rehabilitation program that emphasized physical training, information, and coping skills did not find any evidence that potential reactions to being assigned to control groups influenced any of the outcome variables 22. In this trial, non-participants (who did agree to complete assessments) reported lower levels of most problems at baseline compared to participants, potentially indicating a reduced level of need for the intervention.…”

“…Although this compensatory behavior may reduce the likelihood of identifying a true intervention effect and cloud the results of the study 22, it is an understandable response on the part of participants. Furthermore, it may be viewed as unethical in some situations to try to prevent this type of help-seeking.…”

Determinants of participation in social support groups for prostate cancer patients

“…There are some studies that compare support group participants and non-participants of support groups [33,34]. However, this is the first study to examine different factors in their interrelation, resulting in knowledge about the relative importance of different factors in the interest for and the use of prostate cancer social support groups.…”