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Schröder J, Dinse H, Maria Jahre L, Skoda EM, Stettner M, Kleinschnitz C, Teufel M, Bäuerle A. Needs and Demands for e-Health Symptom Management Interventions in Patients with Post-COVID-19 Condition: A User-Centered Design Approach. Telemed J E Health 2024. [PMID: 38814744 DOI: 10.1089/tmj.2024.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
Introduction: Post-COVID-19 is an increasing chronic disease for which potential treatment options require further development and examination. A well-established approach to symptom management in post-COVID-19 patients could be e-Health interventions. To enhance the implementation and utilization of e-Health interventions, the needs and demands of patients should be taken into consideration. The aim of this study was to investigate needs and demands of post-COVID-19 patients concerning e-Health symptom management interventions. Methods: A total of 556 patients participated in this cross-sectional online survey study. Recruitment was performed from January 19 to May 24, 2022. Data related to the needs and demands for e-Health interventions were analyzed, along with medical and sociodemographic information. Results: The majority of the patients preferred interventions accessible on smartphones (95.3%). The favored content formats were applications (82.7%), interactive training (69.3%), or audio and video materials (61.1%). Furthermore, the preferred session length was about 10-20 min. The most desired topics included "quality of life," "information about how intensively I may exert myself or do sports," "adjustment to new life situation," and "handling physical changes." Conclusions: This study provides a detailed framework for the content and design of e-Health interventions to support patients managing their post-COVID-19 symptoms. The findings could significantly influence the further development of tailored e-Health interventions to address this pressing global health concern.
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Affiliation(s)
- Julia Schröder
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Hannah Dinse
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Lisa Maria Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Mark Stettner
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, Essen, Germany
| | - Christoph Kleinschnitz
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
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Goetzinger C, Alleaume C, Schritz A, Vrijens B, Préau M, Fagherazzi G, Huiart L. Analysing breast cancer survivors’ acceptance profiles for using an electronic pillbox connected to a smartphone application using Seintinelles, a French community-based research tool. Front Pharmacol 2022; 13:889695. [PMID: 36238564 PMCID: PMC9551449 DOI: 10.3389/fphar.2022.889695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: Up to 50% of breast cancer (BC) survivors discontinue their adjuvant endocrine therapy (AET) before the recommended 5 years, raising the issue of medication non-adherence. eHealth technologies have the potential to support patients to enhance their medication adherence and may offer an effective way to complement the healthcare. In order for eHealth technologies to be successfully implemented into the healthcare system, end-users need to be willing and accepting to use these eHealth technologies. Aim: This study aims to evaluate the current usability of eHealth technologiesin and to identify differences in BC SURVIVORS BC survivors accepting a medication adherence enhancing eHealth technology to support their AET to BC survivors that do not accept such a medication adherence enhancing eHealth technology. Methods: This study was conducted in 2020 including volunteering BC survivors belonging to the Seintinelles Association. Eligible participants were women, diagnosed with BC within the last 10 years, and been exposed to, an AET. Univariable and multivariable logistic regression analyses were performed to investigate medication adherence enhancing eHealth technology acceptance profiles among BC survivors. The dependent variable was defined as acceptance of an electronic pillbox connected to a smartphone application (hereafter: medication adherence enhancing eHealth technology). Results: Overall, 23% of the participants already use a connected device or health application on a regular basis. The mean age of the participants was 52.7 (SD 10.4) years. In total, 67% of 1268 BC survivors who participated in the survey declared that they would accept a medication adherence enhancing eHealth technology to improve their AET. BC survivors accepting a medication adherence enhancing eHealth technology for their AET, are younger (OR = 0.97, 95% CI [0.95; 0.98]), do take medication for other diseases (OR = 0.31, 95% CI [0.13; 0.68]), already use a medication adherence enhancing eHealth technology or technique (OR = 1.74, 95% CI [1.06; 2.94]) and are willing to possess or currently possess one or more connected devices or health applications (OR = 2.89, 95% CI [2.01; 4.19]). Conclusion: Understanding acceptance profiles of BC survivors is fundamental for conceiving an effective eHealth technology enhancing AET among BC survivors. Hence, such profiling will foster the development of personalized medication adherence enhancing eHealth technology.
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Affiliation(s)
- Catherine Goetzinger
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- University of Luxembourg, Faculty of Science, Technology and Medicine, Esch-sur-Alzette, Luxembourg
- *Correspondence: Catherine Goetzinger,
| | | | - Anna Schritz
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Bernard Vrijens
- AARDEX Group & Department of Public Health, Liège University, Liège, Belgium
| | - Marie Préau
- Institut de Psychologie, Université Lumière Lyon 2, Lyon, France
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- University of Luxembourg, Faculty of Science, Technology and Medicine, Esch-sur-Alzette, Luxembourg
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Chau JPC, Liu X, Lo SHS, Chien WT, Hui SK, Choi KC, Zhao J. Perioperative enhanced recovery programmes for women with gynaecological cancers. Cochrane Database Syst Rev 2022; 3:CD008239. [PMID: 35289396 PMCID: PMC8922407 DOI: 10.1002/14651858.cd008239.pub5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Gynaecological cancers account for 15% of newly diagnosed cancer cases in women worldwide. In recent years, increasing evidence demonstrates that traditional approaches in perioperative care practice may be unnecessary or even harmful. The enhanced recovery after surgery (ERAS) programme has therefore been gradually introduced to replace traditional approaches in perioperative care. There is an emerging body of evidence outside of gynaecological cancer which has identified that perioperative ERAS programmes decrease length of postoperative hospital stay and reduce medical expenditure without increasing complication rates, mortality, and readmission rates. However, evidence-based decisions on perioperative care practice for major surgery in gynaecological cancer are limited. This is an updated version of the original Cochrane Review published in Issue 3, 2015. OBJECTIVES To evaluate the beneficial and harmful effects of perioperative enhanced recovery after surgery (ERAS) programmes in gynaecological cancer care on length of postoperative hospital stay, postoperative complications, mortality, readmission, bowel functions, quality of life, participant satisfaction, and economic outcomes. SEARCH METHODS We searched the following electronic databases for the literature published from inception until October 2020: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PubMed, AMED (Allied and Complementary Medicine), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus, and four Chinese databases including the China Biomedical Literature Database (CBM), WanFang Data, China National Knowledge Infrastructure (CNKI), and Weipu Database. We also searched four trial registration platforms and grey literature databases for ongoing and unpublished trials, and handsearched the reference lists of included trials and accessible reviews for relevant references. SELECTION CRITERIA We included randomised controlled trials (RCTs) that compared ERAS programmes for perioperative care in women with gynaecological cancer to traditional care strategies. DATA COLLECTION AND ANALYSIS Two review authors independently screened studies for inclusion, extracted the data and assessed methodological quality for each included study using the Cochrane risk of bias tool 2 (RoB 2) for RCTs. Using Review Manager 5.4, we pooled the data and calculated the measures of treatment effect with the mean difference (MD), standardised mean difference (SMD), and risk ratio (RR) with a 95% confidence interval (CI) to reflect the summary estimates and uncertainty. MAIN RESULTS We included seven RCTs with 747 participants. All studies compared ERAS programmes with traditional care strategies for women with gynaecological cancer. We had substantial concerns regarding the methodological quality of the included studies since the included RCTs had moderate to high risk of bias in domains including randomisation process, deviations from intended interventions, and measurement of outcomes. ERAS programmes may reduce length of postoperative hospital stay (MD -1.71 days, 95% CI -2.59 to -0.84; I2 = 86%; 6 studies, 638 participants; low-certainty evidence). ERAS programmes may result in no difference in overall complication rates (RR 0.71, 95% CI 0.48 to 1.05; I2 = 42%; 5 studies, 537 participants; low-certainty evidence). The certainty of evidence was very low regarding the effect of ERAS programmes on all-cause mortality within 30 days of discharge (RR 0.98, 95% CI 0.14 to 6.68; 1 study, 99 participants). ERAS programmes may reduce readmission rates within 30 days of operation (RR 0.45, 95% CI 0.22 to 0.90; I2 = 0%; 3 studies, 385 participants; low-certainty evidence). ERAS programmes may reduce the time to first flatus (MD -0.82 days, 95% CI -1.00 to -0.63; I2 = 35%; 4 studies, 432 participants; low-certainty evidence) and the time to first defaecation (MD -0.96 days, 95% CI -1.47 to -0.44; I2 = 0%; 2 studies, 228 participants; low-certainty evidence). The studies did not report the effects of ERAS programmes on quality of life. The evidence on the effects of ERAS programmes on participant satisfaction was very uncertain due to the limited number of studies. The adoption of ERAS strategies may not increase medical expenditure, though the evidence was of very low certainty (SMD -0.22, 95% CI -0.68 to 0.25; I2 = 54%; 2 studies, 167 participants). AUTHORS' CONCLUSIONS Low-certainty evidence suggests that ERAS programmes may shorten length of postoperative hospital stay, reduce readmissions, and facilitate postoperative bowel function recovery without compromising participant safety. Further well-conducted studies are required in order to validate the certainty of these findings.
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Affiliation(s)
- Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xu Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Suzanne Hoi Shan Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Sze Ki Hui
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, China
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jie Zhao
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Zeng Z, Deng Y, Liu J, Yang K, Peng H, Jiang Y. Chinese Cancer Patients' Attitudes Toward Psychotherapy and Their Willingness to Participate in Clinical Trials of Psychotherapy. Cancer Control 2022; 29:10732748221112664. [PMID: 35786004 PMCID: PMC9260575 DOI: 10.1177/10732748221112664] [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] [Indexed: 02/05/2023] Open
Abstract
Introduction Psychotherapy is considered part of the standard treatment of cancer in
Western countries. However, there is no literature on the attitudes of
Chinese cancer patients toward psychotherapy. Methods: In a multicenter, cross-sectional study in China, a homemade questionnaire
was delivered to cancer patients. The targeted population was Chinese
hospitalized cancer patients who were informed of their state of
illness. Results Five hundred and fifty cancer patients received our questionnaire, and 83.3%
completed the questionnaire. Among the 458 patients, 43.2% indicated that
they had never heard of psychotherapy before the survey. However, after a
brief introduction of psychotherapy, most (92.1%) cancer patients indicated
that psychotherapy is essential for cancer patients, and over half of
patients (57.4%) were willing to take psychotherapy on the advice of the
oncologist in charge. Participants aged 45 years or younger, had a family
income > 10000 yuan per month, and had an ECOG PS (Eastern Cooperative
Oncology Group Performance Status) of 2-4 were more willing to receive
psychotherapy. Of all patients, 59.2% and 57.6% were willing to participate
in individual and group psychotherapy clinical trials, respectively.
Participants who had a bachelor’s degree or higher (odds ratio, OR = 2.09)
and were aged 45 years or younger (OR = 1.67) were more willing to
participate in individual and group psychotherapy clinical trials,
respectively. Conclusion The unmet psychological needs of cancer patients in China remain high, and
doctors’ advice is likely to positively impact the patients’ acceptance of
psychotherapy. Psychological education for Chinese cancer patients should be
strengthened. More high-quality clinical trials of psychotherapy should be
conducted in China to achieve greater benefits for cancer patients and their
families.
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Affiliation(s)
- Zhi Zeng
- Department of Medical Oncology, Cancer Center, West China Hospital, 34753Sichuan University, Chengdu, People's Republic of China
| | - Yaotiao Deng
- Department of Medical Oncology, Cancer Center, West China Hospital, 34753Sichuan University, Chengdu, People's Republic of China
| | - Jie Liu
- Department of Medical Oncology, Cancer Center, West China Hospital, 34753Sichuan University, Chengdu, People's Republic of China
| | - Keyi Yang
- Department of Medical Oncology, Cancer Center, West China Hospital, 34753Sichuan University, Chengdu, People's Republic of China
| | - Hu Peng
- Department of Medical Oncology, Cancer Center, West China Hospital, 34753Sichuan University, Chengdu, People's Republic of China
| | - Yu Jiang
- Department of Medical Oncology, Cancer Center, West China Hospital, 34753Sichuan University, Chengdu, People's Republic of China
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Heinen J, Bäuerle A, Schug C, Krakowczyk JB, Strunk SE, Wieser A, Beckord J, Jansen C, Dries S, Pantförder M, Erim Y, Zipfel S, Mehnert-Theuerkauf A, Wiltink J, Wünsch A, Dinkel A, Stengel A, Kruse J, Teufel M, Graf J. Mindfulness and skills-based eHealth intervention to reduce distress in cancer-affected patients in the Reduct trial: Intervention protocol of the make it training optimized. Front Psychiatry 2022; 13:1037158. [PMID: 36387004 PMCID: PMC9650647 DOI: 10.3389/fpsyt.2022.1037158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Cancer-affected patients experience high distress due to various burdens. One way to expand psycho-oncological support is through digital interventions. This protocol describes the development and structure of a web-based psycho-oncological intervention, the Make It Training optimized. This intervention is currently evaluated in the Reduct trial, a multicenter randomized controlled trial. METHODS The Make It Training optimized was developed in six steps: A patient need and demand assessment, development and acceptability analysis of a prototype, the formation of a patient advisory council, the revision of the training, implementation into a web app, and the development of a motivation and evaluation plan. RESULTS Through a process of establishing cancer-affected patients' needs, prototype testing, and patient involvement, the Make It Training optimized was developed by a multidisciplinary team and implemented in a web app. It consists of 16 interactive self-guided modules which can be completed within 16 weeks. DISCUSSION Intervention protocols can increase transparency and increase the likelihood of developing effective web-based interventions. This protocol describes the process and results of developing a patient-oriented intervention. Future research should focus on the further personalization of web-based psycho-oncological interventions and the potential benefits of combining multiple psychotherapeutic approaches.
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Affiliation(s)
- Jana Heinen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.,Comprehensive Cancer Center (CCC-TS), University Hospital Tübingen, Tübingen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.,Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Julia Barbara Krakowczyk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.,Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
| | - Sven Erik Strunk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexandra Wieser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.,Comprehensive Cancer Center (CCC-TS), University Hospital Tübingen, Tübingen, Germany
| | - Jil Beckord
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.,Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
| | - Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.,Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
| | - Sebastian Dries
- Fraunhofer Institute for Software and Systems Engineering (ISST), Dortmund, Germany
| | - Michael Pantförder
- Fraunhofer Institute for Software and Systems Engineering (ISST), Dortmund, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.,Comprehensive Cancer Center (CCC-TS), University Hospital Tübingen, Tübingen, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, 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, Freiburg Medical Center, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany.,Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.,Comprehensive Cancer Center (CCC-TS), University Hospital Tübingen, Tübingen, Germany.,Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Johannes Kruse
- Department of Psychotherapy and Psychosomatics, Justus Liebig University Giessen, Giessen, Germany.,Department of Psychotherapy and Psychosomatics, Philipps University Marburg, Marburg, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.,Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.,Comprehensive Cancer Center (CCC-TS), University Hospital Tübingen, Tübingen, Germany
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Ghanbari E, Yektatalab S, Mehrabi M. Effects of Psychoeducational Interventions Using Mobile Apps and Mobile-Based Online Group Discussions on Anxiety and Self-Esteem in Women With Breast Cancer: Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e19262. [PMID: 34003138 PMCID: PMC8170553 DOI: 10.2196/19262] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 01/02/2021] [Accepted: 03/19/2021] [Indexed: 12/30/2022] Open
Abstract
Background Psychoeducation has turned into an effective tool in taking care of cancer patients and improving their psychophysical symptoms and quality of life. Despite the growing use of mobile phone apps in medical settings for improving health, evidence supporting their effectiveness in the psychoeducation of patients with breast cancer is rarely available. Objective This study was conducted to investigate the effect of psychoeducational interventions on anxiety and self-esteem in women with breast cancer using a mobile app and an online support group. Methods An unblinded randomized controlled trial based on mobile phones was conducted in Shiraz, Iran. A research assistant recruited 82 women with nonmetastatic breast cancer aged 20 to 60 years were from clinics during a face-to-face visit at the point of care and randomly assigned to an intervention group (n=41) and a wait-list control group (n=41) through blocked randomization. The intervention group received psychoeducational interventions through a mobile phone app and participated in nurse-assisted online mobile support sessions for a total four weeks, whereas the control group was put on a waiting list. The State-Trait Anxiety Inventory (STAI) and the Rosenberg Self-Esteem Scale (RSES) were used to measure the levels of anxiety and self-esteem as the main outcomes at baseline and one week after the intervention. Results A total of 82 patients with a mean age of 46.45 (SD 9.29) years recruited in Winter 2016 were randomly assigned to a wait-list control group (n=41) and intervention group (n=41). Five patients dropped out for different reasons. Comparing the postintervention mean scores of anxiety and its subscales using the independent t test showed statistically significant differences between the mobile psychoeducation group and controls (P<.001). The paired t test used to compare the postintervention mean scores of anxiety with its preintervention scores in the intervention group showed significant reductions in the scores of anxiety (95% CI –17.44 to –8.90, P<.001, d=1.02) and its two subscales (state anxiety: 95% CI –9.20 to –4.21, P<.001, d=0.88 and trait anxiety: 95% CI –8.50 to –4.12, P<.001, d=0.94). Comparing the postintervention mean scores of self-esteem showed statistically insignificant differences between the control and intervention groups (16.87 vs 17.97, P=.24). In contrast with the controls, using the paired t test showed that the increase in the postintervention mean scores of self-esteem were statistically significant in the intervention group compared with the preintervention scores (mean difference 2.05, 95% CI 1.28 to 2.82, P<.001). Conclusions This study demonstrated the key role of mobile apps in decreasing anxiety and improving self-esteem in women with breast cancer through psychoeducational interventions. Similar studies with longer follow-ups are recommended that be conducted in this context. Trial Registration Iranian Registry of Clinical Trials IRCT2015072123279N2; https://en.irct.ir/trial/19882
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Affiliation(s)
- Elaheh Ghanbari
- Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Yektatalab
- Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Community-Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Manoosh Mehrabi
- Department of E-Learning Planning in Medical Sciences, Virtual School, Shiraz University of Medical Sciences, Shiraz, Iran
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7
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Supporting Medical Staff from Psycho-Oncology with Smart Mobile Devices: Insights into the Development Process and First Results. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105092. [PMID: 34064987 PMCID: PMC8150950 DOI: 10.3390/ijerph18105092] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/29/2021] [Accepted: 05/04/2021] [Indexed: 12/11/2022]
Abstract
Cancer is a very distressing disease, not only for the patients themselves, but also for their family members and relatives. Therefore, patients are regularly monitored to decide whether psychological treatment is necessary and applicable. However, such monitoring processes are costly in terms of required staff and time. Mobile data collection is an emerging trend in various domains. The medical and psychological field benefits from such an approach, which enables experts to quickly collect a large amount of individual health data. Mobile data collection applications enable a more holistic view of patients and assist psychologists in taking proper actions. We developed a mobile application, FeelBack, which is designed to support data collection that is based on well-known and approved psychological instruments. A controlled pilot evaluation with 60 participants provides insights into the feasibility of the developed platform and it shows the initial results. 31 of these participants received paper-based questionnaire and 29 followed the digital approach. The results reveal an increase of the overall acceptance by 58.5% in the mean when using a digital screening as compared to the paper-based. We believe that such a platform may significantly improve cancer patients’ and relatives’ psychological treatment, as available data can be used to optimize treatment.
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8
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Bäuerle A, Teufel M, Schug C, Skoda EM, Beckmann M, Schäffeler N, Junne F, Erim Y, Zipfel S, Graf J. Web-based MINDfulness and Skills-based distress reduction in cancer (MINDS): study protocol for a multicentre observational healthcare study. BMJ Open 2020; 10:e036466. [PMID: 32792437 PMCID: PMC7430431 DOI: 10.1136/bmjopen-2019-036466] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Although a high percentage of patients with cancer experience severe psychological distress, few of them receive psycho-oncological care, largely due to barriers on the side of patients and healthcare providers that pose great challenges to delivering such care. In response, low-threshold, self-guided eHealth interventions can enable patients with cancer to deal independently and effectively with disease-related challenges and distress. Mindfulness and Skills-Based Distress Reduction in Oncology Training, nicknamed Make It Training, is one such innovative, self-guided eHealth intervention. In our study, we propose to assess different characteristics of such patients in order to define target populations for Make It Training, evaluate the intervention in terms of its usability, feasibility and sustainability and gather longitudinal data concerning the intervention's efficacy. METHODS AND ANALYSIS Self-guided and web-based Make It Training consists of eight 30 min modules involving the use of techniques of mindfulness therapy, cognitive-behavioural therapy and acceptance and commitment therapy to be completed in a 4-month period. In our observational study, adult patients with cancer who possess adequate German language skills and provide their informed consent will be recruited at Essen, Erlangen and Tübingen University Hospitals at outpatient oncological institutions and via online channels. Patients will undergo a baseline online assessment (T0), an assessment directly after completing the intervention (T1) and assessments 3 and 6 months later (T2 and T3, respectively). With the results of those assessments, we will perform descriptive analyses of their sociodemographic and medical data, compare means and conduct regression analyses. ETHICS AND DISSEMINATION The Ethics Committees of the University Hospitals Essen, Erlangen and Tübingen have approved the study (19-8643-BO, 27_19 B, 293/2018BO1). Results will be published in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER DRKS00017119.
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Affiliation(s)
- Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center Essen, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center Essen, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center Essen, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany
| | - Mingo Beckmann
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Comprehensive Cancer Center Essen, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany
| | - Norbert Schäffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Baden-Württemberg, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Baden-Württemberg, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Baden-Württemberg, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Baden-Württemberg, Germany
- Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
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Chow PI, Showalter SL, Gerber M, Kennedy EM, Brenin D, Mohr DC, Lattie EG, Gupta A, Ocker G, Cohn WF. Use of Mental Health Apps by Patients With Breast Cancer in the United States: Pilot Pre-Post Study. JMIR Cancer 2020; 6:e16476. [PMID: 32293570 PMCID: PMC7191345 DOI: 10.2196/16476] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/19/2019] [Accepted: 01/27/2020] [Indexed: 12/16/2022] Open
Abstract
Background Nearly half of the patients with breast cancer experience clinically significant mental distress within the first year of receiving their cancer diagnosis. There is an urgent need to identify scalable and cost-efficient ways of delivering empirically supported mental health interventions to patients with breast cancer. Objective The aim of this study was to evaluate the feasibility of in-clinic recruitment for a mobile phone app study and to evaluate the usability and preliminary impact of a suite of mental health apps (IntelliCare) with phone coaching on psychosocial distress symptoms in patients recently diagnosed with breast cancer. Methods This pilot study adopted a within-subject, 7-week pre-post study design. A total of 40 patients with breast cancer were recruited at a US National Cancer Institute–designated clinical cancer center. Self-reported distress (Patient Health Questionnaire-4) and mood symptoms (Patient-Reported Outcomes Measurement Information System depression and anxiety scales) were assessed at baseline and postintervention. App usability was assessed at postintervention. Results The minimum recruitment threshold was met. There was a significant decrease in general distress symptoms, as well as symptoms of depression and anxiety, from baseline to postintervention. Overall, participants reported high levels of ease of app use and learning. Scores for app usefulness and satisfaction were reinforced by some qualitative feedback suggesting that tailoring the apps more for patients with breast cancer could enhance engagement. Conclusions There is a dire need for scalable, supportive interventions in cancer. The results from this study inform how scalable mobile phone–delivered programs with additional phone support can be used to support patients with breast cancer. International Registered Report Identifier (IRRID) RR2-10.2196/11452
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Affiliation(s)
- Philip I Chow
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
| | - Shayna L Showalter
- Department of Surgery, University of Virginia, Charlottesville, VA, United States
| | - Matthew Gerber
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States
| | - Erin M Kennedy
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - David Brenin
- Department of Surgery, University of Virginia, Charlottesville, VA, United States
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Emily G Lattie
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Alisha Gupta
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Gabrielle Ocker
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Wendy F Cohn
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
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10
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Chow PI, Drago F, Kennedy EM, Cohn WF. A Novel Mobile Phone App Intervention With Phone Coaching to Reduce Symptoms of Depression in Survivors of Women's Cancer: Pre-Post Pilot Study. JMIR Cancer 2020; 6:e15750. [PMID: 32027314 PMCID: PMC7055784 DOI: 10.2196/15750] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/13/2019] [Accepted: 12/09/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Psychological distress is a major issue among survivors of women's cancer who face numerous barriers to accessing in-person mental health treatments. Mobile phone app-based interventions are scalable and have the potential to increase access to mental health care among survivors of women's cancer worldwide. OBJECTIVE This study aimed to evaluate the acceptability and preliminary efficacy of a novel app-based intervention with phone coaching in a sample of survivors of women's cancer. METHODS In a single-group, pre-post, 6-week pilot study in the United States, 28 survivors of women's cancer used iCanThrive, a novel app intervention that teaches skills for coping with stress and enhancing well-being, with added phone coaching. The primary outcome was self-reported symptoms of depression (Center for Epidemiologic Studies Depression Scale). Emotional self-efficacy and sleep disruption were also assessed at baseline, 6-week postintervention, and 4 weeks after the intervention period. Feedback obtained at the end of the study focused on user experience of the intervention. RESULTS There were significant decreases in symptoms of depression and sleep disruption from baseline to postintervention. Sleep disruption remained significantly lower at 4-week postintervention compared with baseline. The iCanThrive app was launched a median of 20.5 times over the intervention period. The median length of use was 2.1 min. Of the individuals who initiated the intervention, 87% (20/23) completed the 6-week intervention. CONCLUSIONS This pilot study provides support for the acceptability and preliminary efficacy of the iCanThrive intervention. Future work should validate the intervention in a larger randomized controlled study. It is important to develop scalable interventions that meet the psychosocial needs of different cancer populations. The modular structure of the iCanThrive app and phone coaching could impact a large population of survivors of women's cancer.
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Affiliation(s)
- Philip I Chow
- University of Virginia, Charlottesville, VA, United States
| | - Fabrizio Drago
- University of Virginia, Charlottesville, VA, United States
| | - Erin M Kennedy
- University of Virginia, Charlottesville, VA, United States
| | - Wendy F Cohn
- University of Virginia, Charlottesville, VA, United States
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Villani D, Cognetta C, Repetto C, Serino S, Toniolo D, Scanzi F, Riva G. Promoting Emotional Well-Being in Older Breast Cancer Patients: Results From an eHealth Intervention. Front Psychol 2018; 9:2279. [PMID: 30538650 PMCID: PMC6277478 DOI: 10.3389/fpsyg.2018.02279] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/01/2018] [Indexed: 12/21/2022] Open
Abstract
Breast cancer is the most common cancer in women worldwide, with increases in diagnoses at all ages. Due to several age-related factors, older breast cancer patients show particular difficulties in adjusting to breast cancer and its related treatments. One consistent indicator of vulnerability to long-term complications is emotional distress occurring within 3 months of diagnosis. Thus, it is critical to develop early interventions specifically aimed at mitigating distress and promoting emotional wellbeing in older breast cancer patients. By taking advantage of the opportunities of online interventions, the present study aimed to test the efficacy of a 2 weeks e-health stress inoculation training (SIT) intervention on emotion regulation and cancer-related well-being, compared with a control group without such intervention. Twenty-nine women with a diagnosis of breast cancer, who had received radical surgery and who were suitable candidates for adjuvant chemotherapy with anthracyclines and taxanes (mean age = 62.76; SD = 6.19) voluntarily took part in the current study after giving written informed consent. To test intervention efficacy, self-report questionnaires were administered to all participants at baseline, at the end of the 2 weeks intervention, and 3 months after the end of the intervention. Results showed that after 2 weeks of ehealth intervention, patients did not achieve significant change, however, they significantly reduced emotional suppression and increased cancer-related emotional well-being 3 months after the end of the intervention. Furthermore, by monitoring at a distance the emotional experience during the online intervention, we found an increase in relaxation and a reduction of anxiety. Finally, patients in the experimental group reported a good level of acceptance of the ehealth intervention. To conclude, designing and developing eHealth interventions as part of the regular care path for breast cancer patients of all ages represents both a challenge and an opportunity; in particular, online interventions can be an important step in universal psychosocial care within a tiered model of care.
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Affiliation(s)
- Daniela Villani
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Chiara Cognetta
- Department of Medical Oncology, G.Salvini ASST Rhodense, Milan, Italy
| | - Claudia Repetto
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Silvia Serino
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Davide Toniolo
- Department of Medical Oncology, G.Salvini ASST Rhodense, Milan, Italy
| | - Francesco Scanzi
- U.O. Oncologia Medica, Ospedale S. Giuseppe-Multimedica, Milan, Italy
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
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