Working mechanisms of a web-based self-management intervention for cancer survivors: a randomised controlled trial

Abstract

Objective: The aim of this study was to investigate whether problem-solving skills and perceived personal control over cancer recovery mediated the intervention effects on depression and fatigue of a web-based computertailored intervention for cancer survivors -the Kanker Nazorg Wijzer (Cancer Aftercare Guide). Design: Patients were recruited through 21 Dutch hospitals (November 2013-June 2014. The mediation model was tested in a randomised controlled trial with an intervention group (n = 231) and a waiting list control group (n = 231). Main outcome measures: Hypothesised mediators problem-solving skills (SPSI-R) and personal control (IPQ-R) were measured at baseline and 3 months from baseline. Outcomes depression (HADS) and fatigue (CIS) were measured at baseline and 6 months from baseline. Results: The intervention effects in decreasing depression and fatigue were mediated by personal control. Problem-solving skills did not mediate the intervention effects on depression and fatigue. Conclusion: While personal control in the control group decreased in the first three months after baseline, levels of personal control within the intervention group were maintained. This effect partially explained the intervention effects on depression and fatigue. The results provide evidence for the relevance of addressing personal control in web-based interventions in order to improve psychosocial well-being in early cancer survivors.

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

“…Both groups had to fill in a questionnaire at baseline and after 3, 6, and 12 months from baseline. The 3-month measurement measured possible mediating variables [ 37 ], while the 6- and 12-month measurement aimed to measure the short- and long-term effectiveness of the intervention, respectively. The intervention group had access to the KNW for 6 months directly after baseline.…”

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).…”

Psychological adjustment in patients post-curative treatment for oesophageal cancer: a longitudinal interview study

“…For the oesophageal cancer patient, fostering realistic expectations in accepting an on-going process of trial and error towards effective symptom management would be important. A useful example is a web-based self-management intervention for cancer patients (Willems et al, 2017), successfully instilling self-efficacy/personal control beliefs through the provision of individualised, disease specific information, through use of Cognitive Behavioural Therapy (CBT) monitoring and setting realistic goals, and the use of fellow patients and clinicians as models to provide information on expectations and discuss problem-solving techniques for ongoing symptom management.…”