TY - JOUR
T1 - Psychoeducational intervention to reduce fear of cancer recurrence in people at high risk of developing another primary melanoma
T2 - results of a randomized controlled trial
AU - Dieng, Mbathio
AU - Butow, Phyllis N.
AU - Costa, Daniel S. J.
AU - Morton, Rachael L.
AU - Menzies, Scott W.
AU - Mireskandari, Shab
AU - Tesson, Stephanie
AU - Mann, Graham J.
AU - Cust, Anne E.
AU - Kasparian, Nadine A.
PY - 2016/12/20
Y1 - 2016/12/20
N2 - PurposePeople with a history of melanoma commonly report a fear of cancer recurrence (FCR), yet psychologic support is not routinely offered as part of ongoing melanoma care. This randomized controlled trial examined the efficacy of a psychoeducational intervention to reduce FCR and improve psychologic adjustment in this patient group compared with usual care.MethodsThe intervention comprised a newly developed psychoeducational resource and three telephone-based psychotherapeutic sessions over a 1-month period timed in accordance with dermatologic appointments. Participants were randomly assigned to intervention (n = 80) or usual care (n = 84). Assessments were completed at baseline, 1 month, and 6 months after dermatologic appointments. Linear mixed models were used to examine differences between treatment and control groups for patient-reported outcomes, including FCR, anxiety, stress, depression, melanoma-related knowledge, health behaviors, satisfaction with melanoma care, unmet needs, and health-related quality of life.ResultsAt 6 months, the intervention group reported lower FCR severity, trigger, and distress scores than the control group in the baseline-adjusted models; the between-group mean difference was −1.9 for FCR severity (95% CI, −3.1 to −0.7; P = .002), −2.0 for FCR triggers (95% CI, −3.3 to −0.7; P = .003), and −0.7 for FCR distress (95% CI, −1.3 to −0.1; P = .03). The decrease in FCR severity (but not triggers or distress) remained statistically significant after adjustment for other covariates (P = .04). At 6 months, the intervention group also reported lower stress (−1.6; 95% CI, −3.1 to −0.2; P = .03) and improved melanoma-related knowledge (1.7; 95% CI, 0.8 to 2.6; P < .001) compared with the control group. No differences were found between groups for other secondary outcomes.ConclusionThis newly developed evidence-based psychoeducational intervention was effective in reducing FCR and stress and increasing melanoma-related knowledge in people at high risk for another melanoma.
AB - PurposePeople with a history of melanoma commonly report a fear of cancer recurrence (FCR), yet psychologic support is not routinely offered as part of ongoing melanoma care. This randomized controlled trial examined the efficacy of a psychoeducational intervention to reduce FCR and improve psychologic adjustment in this patient group compared with usual care.MethodsThe intervention comprised a newly developed psychoeducational resource and three telephone-based psychotherapeutic sessions over a 1-month period timed in accordance with dermatologic appointments. Participants were randomly assigned to intervention (n = 80) or usual care (n = 84). Assessments were completed at baseline, 1 month, and 6 months after dermatologic appointments. Linear mixed models were used to examine differences between treatment and control groups for patient-reported outcomes, including FCR, anxiety, stress, depression, melanoma-related knowledge, health behaviors, satisfaction with melanoma care, unmet needs, and health-related quality of life.ResultsAt 6 months, the intervention group reported lower FCR severity, trigger, and distress scores than the control group in the baseline-adjusted models; the between-group mean difference was −1.9 for FCR severity (95% CI, −3.1 to −0.7; P = .002), −2.0 for FCR triggers (95% CI, −3.3 to −0.7; P = .003), and −0.7 for FCR distress (95% CI, −1.3 to −0.1; P = .03). The decrease in FCR severity (but not triggers or distress) remained statistically significant after adjustment for other covariates (P = .04). At 6 months, the intervention group also reported lower stress (−1.6; 95% CI, −3.1 to −0.2; P = .03) and improved melanoma-related knowledge (1.7; 95% CI, 0.8 to 2.6; P < .001) compared with the control group. No differences were found between groups for other secondary outcomes.ConclusionThis newly developed evidence-based psychoeducational intervention was effective in reducing FCR and stress and increasing melanoma-related knowledge in people at high risk for another melanoma.
UR - http://www.scopus.com/inward/record.url?scp=85009754939&partnerID=8YFLogxK
U2 - 10.1200/JCO.2016.68.2278
DO - 10.1200/JCO.2016.68.2278
M3 - Article
C2 - 27998215
AN - SCOPUS:85009754939
VL - 34
SP - 4405
EP - 4414
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 1527-7755
IS - 36
ER -