1
|
Svendsen K, Nes LS, Meland A, Larsson IM, Gjelsvik YM, Børøsund E, Rygg CM, Myklebust TÅ, Reinertsen KV, Kiserud CE, Skjerven H, Antoni MH, Chalder T, Mjaaland I, Carlson LE, Eriksen HR, Ursin G. Coping After Breast Cancer (CABC): Protocol for a randomized controlled trial of stress management e-health interventions. JMIR Res Protoc 2023; 12:e47195. [PMID: 37103493 DOI: 10.2196/47195] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/15/2023] [Accepted: 04/23/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND One-third or more of breast cancer survivors report stress and other psychological and physical complaints that can negatively impact quality of life. Psychosocial stress-management interventions, shown to mitigate the negative impact of these complaints, can now be delivered as accessible and convenient (for the patient and provider) e-health interventions. In the present randomized controlled trial (RCT), Coping After Breast Cancer (CABC), two modified versions of the stress management e-health intervention program StressProffen were created: one with predominantly cognitive-behavioral stress-management content (Stressproffen-CBI) and one with predominantly mindfulness-based stress-management content (StressProffen-MBI). OBJECTIVE To investigate the effects in breast cancer survivors of using StressProffen-CBI and StressProffen-MBI compared to a control group (treatment as usual). METHODS Women diagnosed with breast cancer (stage I-III, unequivocally HER2+ or ER- tumors) or DCIS aged 21-69 years who completed the Cancer Registry of Norway- initiated health survey on quality of life, are invited to the CABC trial about seven months after diagnosis. Women who give consent to participate are randomized (1:1:1) to: Stressproffen-CBI, Stressproffen-MBI, or control group. Both Stressproffen interventions consist of 10 modules of stress management content delivered through text, sound, video, and images. The primary outcome is between-groups changes in perceived stress at six months, assessed with Cohen's Perceived Stress Scale. Secondary outcomes comprise changes in quality of life, anxiety, depression, fatigue, sleep, neuropathy, coping, mindfulness and work-related outcomes approximately 1, 2 and 3 years after diagnosis. Long-term effects of the interventions on work participation, comorbidities, relapse or new cancers and mortality will be obtained from national health registries. RESULTS We plan to recruit 430 participants in total (100 in each group). Recruitment is scheduled from January 2021 through May 2023. CONCLUSIONS The CABC trial is possibly the largest ongoing psychosocial e-health RCT in breast cancer patients at current. If one or both interventions prove to be effective in reducing stress and improving psychosocial and physical complains, the StressProffen e-health interventions could be beneficial, inexpensive, and easily implementable tools for breast cancer survivors when coping with late effects after cancer and cancer treatments. CLINICALTRIAL Clinicaltrials.gov identifier NCT04480203. First posted: July 7th 2020. https://clinicaltrials.gov/ct2/show/NCT04480203.
Collapse
Affiliation(s)
- Karianne Svendsen
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, NO
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, NO
- Lipid Clinic, Oslo University Hospital, Oslo, NO
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, NO
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NO
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, US
| | - Anders Meland
- Department of Sport and Social Sciences, School of Sport Sciences, Oslo, NO
| | - Ine Marie Larsson
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, NO
| | - Ylva M Gjelsvik
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, NO
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, NO
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, NO
| | - Christine M Rygg
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, NO
| | - Tor Åge Myklebust
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, NO
| | - Kristin V Reinertsen
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University hospital, Oslo, NO
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University hospital, Oslo, NO
| | - Helle Skjerven
- Section for Breast and Endocrine Surgery Department, Vestre Viken Hospital Trust, Drammen, NO
| | - Michael H Antoni
- Department of Psychology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, US
| | - Trudie Chalder
- Department of Psychological Medicine, King's College London, London, GB
| | - Ingvil Mjaaland
- Department of Oncology and Hematology, Stavanger University Hospital, Stavanger, NO
| | - Linda E Carlson
- Departments of Oncology and Psychology, University of Calgary, Calgary, CA
| | - Hege R Eriksen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, NO
| | - Giske Ursin
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, NO
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, NO
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, LA, US
| |
Collapse
|
2
|
Milton A, Schandl A, Soliman IW, Meijers K, van den Boogaard M, Larsson IM, Brorsson C, Östberg U, Oxenbøll-Collet M, Savilampi J, Paskins S, Bottai M, Sackey PV. Development of an ICU discharge instrument predicting psychological morbidity: a multinational study. Intensive Care Med 2018; 44:2038-2047. [PMID: 30467678 PMCID: PMC6280826 DOI: 10.1007/s00134-018-5467-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/13/2018] [Indexed: 12/23/2022]
Abstract
Purpose To develop an instrument for use at ICU discharge for prediction of psychological problems in ICU survivors. Methods Multinational, prospective cohort study in ten general ICUs in secondary and tertiary care hospitals in Sweden, Denmark and the Netherlands. Adult patients with an ICU stay ≥ 12 h were eligible for inclusion. Patients in need of neurointensive care, with documented cognitive impairment, unable to communicate in the local language, without a home address or with more than one limitation of therapy were excluded. Primary outcome was psychological morbidity 3 months after ICU discharge, defined as Hospital Anxiety and Depression Scale (HADS) subscale score ≥ 11 or Post-traumatic Stress Symptoms Checklist-14 (PTSS-14) part B score > 45. Results A total of 572 patients were included and 78% of patients alive at follow-up responded to questionnaires. Twenty percent were classified as having psychological problems post-ICU. Of 18 potential risk factors, four were included in the final prediction model after multivariable logistic regression analysis: symptoms of depression [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.10–1.50], traumatic memories (OR 1.44, 95% CI 1.13–1.82), lack of social support (OR 3.28, 95% CI 1.47–7.32) and age (age-dependent OR, peak risk at age 49–65 years). The area under the receiver operating characteristics curve (AUC) for the instrument was 0.76 (95% CI 0.70–0.81). Conclusions We developed an instrument to predict individual patients’ risk for psychological problems 3 months post-ICU, http://www.imm.ki.se/biostatistics/calculators/psychmorb/. The instrument can be used for triage of patients for psychological ICU follow-up. Trial registration The study was registered at clinicaltrials.gov, NCT02679157. Electronic supplementary material The online version of this article (10.1007/s00134-018-5467-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- A Milton
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. .,Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
| | - A Schandl
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - I W Soliman
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - K Meijers
- Department of Anaesthesiology and Intensive Care, Sodersjukhuset, Stockholm, Sweden
| | - M van den Boogaard
- Department of Intensive Care Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - I M Larsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - C Brorsson
- Department of Surgery and Perioperative Science, Umeå University, Umeå, Sweden
| | - U Östberg
- Department of Anaesthesiology and Intensive Care, Östersund Hospital, Östersund, Sweden
| | - M Oxenbøll-Collet
- Department of Intensive Care, Rigshospitalet Copenhagen, Copenhagen, Denmark
| | - J Savilampi
- Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden
| | - S Paskins
- Department of Intensive Care, Odense University Hospital, Odense, Denmark
| | - M Bottai
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - P V Sackey
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
3
|
Fell D, Derbyshire DR, Maile CJ, Larsson IM, Ellis R, Achola KJ, Smith G. Measurement of plasma catecholamine concentrations. An assessment of anxiety. Br J Anaesth 1985; 57:770-4. [PMID: 4015938 DOI: 10.1093/bja/57.8.770] [Citation(s) in RCA: 74] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This study was designed to assess the value of measurement of plasma catecholamine concentrations as an objective index of anxiety. A preliminary study was undertaken on 11 healthy volunteers (medically qualified), to determine if venous cannulation per se produced any change in plasma catecholamine concentrations. There were no changes in plasma catecholamine concentrations in the 2 h following insertion of an i.v. cannula, suggesting that venous cannulation did not induce a measurable stress response. A second study was performed on 48 surgical patients who were asked to rate their perceived anxiety on a linear analogue scale immediately before premedication and immediately before induction of anaesthesia. Venous blood was obtained at the same time as these ratings. There were no significant changes in perceived anxiety or plasma noradrenaline concentrations following premedication. However, compared with values before premedication, there was a mean percentage increase in plasma adrenaline concentration of 40% before induction of anaesthesia. A significant correlation was shown between mean percentage change in Linear Analogue Anxiety Score and mean percentage change in plasma adrenaline concentrations (r = 0.32).
Collapse
|