Short‐term effectiveness of a web‐based tailored intervention for cancer survivors on quality of life, anxiety, depression, and fatigue: randomized controlled trial

Abstract

Purpose The 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. Methods Cancer 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. Results At 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. Conclusions The 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 survivors The 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.

Psychometric properties of the Dutch extended Cancer Survivors’ Unmet Needs measure (CaSUN-NL)

“…During this process, the CaSUN‐NL was extended with five items on return to work and four on lifestyle, because return to work and lifestyle are prominent issues among cancer survivors and cancer survivors may also experience unmet needs in these domains (Demark‐Wahnefried & Jones, 2008; Duijts et al., 2014; Harding, 2012; Küsters, Lechner, Willems, Bolman, & Mesters, 2012; Stergiou‐Kita et al., 2014; Wolin & Colditz, 2013). The CaSUN‐NL was subsequently applied in the two Dutch studies (hereafter called “first study” and “second study”; Kanera, Bolman, Mesters, et al., 2016; Kanera, Bolman, Willems, et al., 2016; Kanera, Willems et al., 2016; Willems et al., 2015, 2016a,b). …”

“…The second study was a randomised controlled trial to evaluate the effectiveness of an e‐Health intervention for cancer survivors on quality of life, anxiety, depression and fatigue (Kanera, Willems et al., 2016; Willems et al., 2015, 2016b). The inclusion criterion (4 weeks to a year after primary treatment) was somewhat longer than in the first study.…”

“…In the Netherlands, only a few studies have identified the unmet needs of cancer survivors (Jansen, van Uden‐Kraan, van Zwieten, Witte, & Verdonck‐de Leeuw, 2015; Kanera, Bolman, Willems, & Mesters, 2016; Pauwels, Charlier, De Bourdeaudhuij, Lechner, & Van Hoof, 2013; Willems et al., 2016a,b). For our two studies (Kanera, Bolman, Mesters, et al., 2016; Willems et al., 2016a), the validated CaSUN was regarded as the most appropriate general questionnaire to specifically investigate the unmet needs of cancer survivors (Bender et al., 2012; Brennan, Butow, Spillane, & Boyle, 2016; Geller et al., 2014; Harrison et al., 2011; Hodgkinson, Butow, Fuchs, et al., 2007; Hodgkinson, Butow, Hunt, et al., 2007; Rowlands, Janda, McKinnon, Webb, & Beesley, 2015; Smith et al., 2013; Urbaniec, Collins, Denson, & Whitford, 2011).…”

Uptake and adherence to an online intervention for cancer-related distress: older age is not a barrier to adherence but may be a barrier to uptake

“…Barriers to accessing therapist-based interventions include limited availability [3], travel distances [4], reluctance to disclose distress [3], and concerns about stigma [3]. In response, online self-help interventions are being increasingly explored [5][6][7][8][9].…”

“…While reports of online interventions for cancer report on overall uptake (e.g. [7][8][9]), little research examines characteristics that predict uptake.…”