Online counseling via e-mail for breast cancer patients on the German internet: preliminary results of a psychoeducational intervention Effects of Online Support Group Format (Moderated vs Peer-Led) on Depressive Symptoms and Extent of Participation in Women With Breast Cancer The association of depression and anxiety with health-related quality of life in cancer patients with depression and/or pain. BREATH: Web-Based Self-Management for Psychological Adjustment After Primary Breast Cancer--Results of a Multicenter Randomized Controlled Trial. Internet-based guided self-help for glioma patients with depressive symptoms: a randomized controlled trial Effectiveness of Two Web-Based Interventions for Chronic Cancer-Related Fatigue Compared to an Active Control Condition: Results of the “Fitter na kanker” Randomized Controlled Trial 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 The effect of individualized patient education, along with emotional support, on the quality of life of breast cancer patients - A pilot study. SAKK 24/09: safety and tolerability of bevacizumab plus paclitaxel vs. bevacizumab plus metronomic cyclophosphamide and capecitabine as first-line therapy in patients with HER2-negative advanced stage breast cancer - a multicenter, randomized phase III trial The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials A Video Game Improves Behavioral Outcomes in Adolescents and Young Adults With Cancer: A Randomized Trial Web-Based Tailored Psychoeducation for Breast Cancer Patients at the Onset of the Survivorship Phase: A Multicenter Randomized Controlled Trial. Web-based stress management for newly diagnosed cancer patients (STREAM-1): a randomized, wait-list controlled intervention study Preliminary results of a randomised controlled trial of an online psychological intervention to reduce distress in men treated for localised prostate cancer. Evaluating the efficacy of a self-guided Web-based CBT intervention for reducing cancer-distress: a randomised controlled trial Effect of brief psychoeducation using a tablet PC on distress and quality of life in cancer patients undergoing chemotherapy: a pilot study. Improving the effectiveness of adjuvant psychological treatment for women with breast cancer: the feasibility of providing online support. Effectiveness of psycho-educational interventions with telecommunication technologies on emotional distress and quality of life of adult cancer patients: a systematic review Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. Effect of Internet peer-support groups on psychosocial adjustment to cancer: a randomised study Patients' supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review A systematic review of cognitive and behavioral treatments for individuals with psoriasis
Objectives : The internet offers new possibilities in psychosocial patient care . However , empirical data are lacking for oncological patients . A field-experimental study was conducted to obtain initial data to enable evaluation of the effectiveness of online counseling via e-mail for breast cancer patients . A secondary objective was to explore how patients reached by the service can be characterized on psychosocial status and illness . Methods : On a dedicated German- language website , 235 breast cancer patients registered for psychosocial counseling via e-mail . 133 registrants were r and omly assigned to a treatment group to receive immediate counseling or to a waiting list control group . The two-month counseling session took the form of a psychoeducation , individually tailored to each patient . Psychosocial outcome measures including psychological distress ( BSI ) and quality of life ( EORTC QLQ-C30 ) were assessed at registration and at a two-month follow-up . Descriptive data were recorded at registration . At the conclusion of the program , participants were asked to complete a patient satisfaction question naire ( ZUF-8 ) . Results : BSI responses showed that 85 % of all patients were initially diagnosable with comorbid psychopathology . Despite high severity of distress and attendant large reductions in quality of life , 72 % of all patients were not obtaining conventional assistance . Among counseling participants ( n=31 ) , no significant improvements in distress or quality of life were found in comparison to the control group ( n=34 ) , but patient satisfaction was nonetheless high . Conclusion : The study demonstrates that online counseling via e-mail reaches patients with unmet therapeutic needs , but also indicated its limitations , suggesting that the online setting may be most useful for prompting and supporting a transition to conventional counseling services The purpose s of this study were to evaluate the effects of different formats of online group support ( moderated vs peer-led ) on depressive symptoms and extent of participation in women with breast cancer . A r and omized longitudinal design was used to address the study aims . The setting was a secure password-protected Web page . Fifty women with breast cancer , at least 21 years old , who had Internet access participated . Subjects were r and omly assigned to moderated or peer-led groups , given a password , and instructed to complete the study question naires at baseline and again at 6 , 12 , and 16 weeks . The independent variables were types of  online support ( moderated or peer-led ) , and the dependent variables were depressive symptoms and extent of participation . There were no significant differences in depressive symptoms by group or by extent of group participation . Moderated groups read and posted significantly more messages than did peer-led groups . This study adds to the research base on different group formats for online support and the extent of participation and nonparticipation ( lurking ) in online groups . It provides a springboard for additional studies that include ethnic minorities , people with different types of cancer , and men OBJECTIVES Depression is known to be a major problem in cancer patients , and evidence is emerging about the importance of anxiety . Because the disorders are highly comorbid , we examined the relationship of anxiety and depression with health-related quality of life ( HRQL ) in cancer patients . METHODS Sample included 405 adult oncology patients participating in a r and omized controlled trial of telecare management for pain and depression .  This secondary cross-sectional analysis of baseline data examined independent and additive effects of anxiety and depression on HRQL , disability , and somatic symptom severity . RESULTS In 397 patients who screened positive for either pain or depression or both , 135 had comorbid anxiety and depression , 174 had depression but not anxiety , and 88 had neither . Differences existed across all nonphysical HRQL domains and were more pronounced incrementally across the three groups in the expected direction . In GLM modeling , anxiety and depression were each associated with all the domains when modeled separately ( p<0.0001 ) . When modeled together , anxiety and depression had independent and additive effects on the mental health domains of HRQL and on somatic symptom burden . In other domains ( vitality , perceived disability , overall quality of life , and general health perceptions ) , only depression had an effect . CONCLUSION Anxiety and depression have strong and independent associations with mental health domains and somatic symptom burden in cancer patients . However , depression has a more pervasive association with multiple other domains of HRQL . Paying attention to both anxiety and depression may be particularly important when addressing mental health needs and somatic symptom distress PURPOSE Early breast cancer survivors ( BCSs ) report high unmet care needs , and easily accessible care is not routinely available for this growing population . The Breast Cancer E-Health ( BREATH ) trial is a Web-based self-management intervention to support the psychological adjustment of women after primary treatment , by reducing distress and improving empowerment . PATIENTS AND METHODS This multicenter , r and omized , controlled , parallel-group trial evaluated whether care as usual ( CAU ) plus BREATH is superior to CAU alone . BREATH is delivered in sixteen fully automated weekly modules covering early survivorship issues . Two to 4 months post-treatment , BCSs were r and omly assigned to receive CAU + BREATH ( n = 70 ) or CAU alone ( n = 80 ) using a stratified block design ( ratio 1:1 ) . Primary outcomes were distress ( Symptom Checklist-90 ) and empowerment ( Cancer Empowerment Question naire ) , assessed before r and om assignment ( baseline , T0 ) and after 4 ( T1 ) , 6 ( T2 ) , and 10 months ( T3 ) of follow-up . Statistical ( analysis of covariance ) and clinical effects ( reliable change index ) were tested in an intention-to-treat analysis ( T0 to T1 ) . Follow-up effects ( T0 to T3 ) were assessed in assessment completers . RESULTS CAU + BREATH participants reported significantly less distress than CAU-alone participants ( -7.79 ; 95 % CI , -14.31 to -1.27 ; P = .02 ) with a small-to-medium effect size ( d = 0.33 ) , but empowerment was not affected ( -1.71 ; 95 % CI , 5.20 to -1.79 ; P = .34 ) . More CAU + BREATH participants ( 39 of 70 [ 56 % ] ; 95 % CI , 44.1 to 66.8 ) than CAU-alone participants ( 32 of 80 [ 40 % ] ; 95 % CI , 30.0 to 51.0 ) showed clinical ly significant improvement ( P = .03 ) . This clinical effect was most prominent in low-distress BCSs . Secondary outcomes confirmed primary outcomes . There were no between-group differences in primary outcomes during follow-up . CONCLUSION Access to BREATH reduced distress among BCSs , but this effect was not sustained during follow-up Abstract Depressive symptoms are common in glioma patients , and can negatively affect health-related quality of life ( HRQOL ) . We performed a nation-wide r and omized controlled trial to evaluate the effects of an online guided self-help intervention for depressive symptoms in adult glioma patients . Glioma patients with depressive symptoms were r and omized to a 5-week online course based on problem-solving therapy , or a waiting list control group . After having received the intervention , the glioma patient groups combined were compared with patients with cancer outside the central nervous system ( non-CNS cancer controls ) , who also received the intervention . Sample size calculations yielded 63 participants to be recruited per arm . The primary outcome [ depressive symptoms ( CES-D ) ] and secondary outcomes [ fatigue ( Checklist Individual Strength ( CIS ) ) and HRQOL ( Short Form-36 ) ] , were assessed online at baseline , post-intervention , and 3 and 12 months follow-up . In total , 89 glioma patients ( intervention N = 45 ; waiting list N = 44 ) and 26 non-CNS cancer controls were included , of whom 35 and 54 % completed the intervention , respectively . Recruitment could not be extended beyond 3.5 years due to funding . On depression , no statistically significant differences between the groups were found . Fatigue decreased post-treatment in the glioma intervention group compared with the waiting list group ( p = 0.054 , d = 0.306 ) . At 12 months , the physical component summary ( HRQOL ) remained stable in glioma patients , while scores improved in non-CNS cancer controls ( p = 0.035 , d = 0.883 ) . In this underpowered study , no evidence for the effectiveness of online guided self-help for depression or HRQOL in glioma patients was found , but it may improve fatigue . Trial registration Netherl and s Trial Register NTR3223 Background Approximately one third of all patients who have been successfully treated for cancer suffer from chronic cancer-related fatigue ( CCRF ) . Effective and easily accessible interventions are needed for these patients . Objective The current paper reports on the results of a 3-armed r and omized controlled trial investigating the clinical effectiveness of two different guided Web-based interventions for reducing CCRF compared to an active control condition . Methods Severely fatigued cancer survivors were recruited via online and offline channels , and self-registered on an open-access website . After eligibility checks , 167 participants were r and omized via an embedded automated r and omization function into : ( 1 ) physiotherapist-guided Ambulant Activity Feedback ( AAF ) therapy encompassing the use of an accelerometer ( n=62 ) ; ( 2 ) psychologist-guided Web-based mindfulness-based cognitive therapy ( eMBCT ; n=55 ) ; or ( 3 ) an unguided active control condition receiving psycho-educational emails ( n=50 ) . All interventions lasted nine weeks . Fatigue severity was self-assessed using the Checklist Individual Strength - Fatigue Severity subscale ( primary outcome ) six times from baseline ( T0b ) to six months ( T2 ) . Mental health was self-assessed three times using the Hospital Anxiety and Depression Scale and Positive and Negative Affect Schedule ( secondary outcome ) . Treatment dropout was investigated . Results Multiple group latent growth curve analysis , corrected for individual time between assessment s , showed that fatigue severity decreased significantly more in the AAF and eMBCT groups compared to the psycho-educational group . The analyses were checked by a research er who was blind to allocation . Clinical ly relevant changes in fatigue severity were observed in 66 % ( 41/62 ) of patients in AAF , 49 % ( 27/55 ) of patients in eMBCT , and 12 % ( 6/50 ) of patients in psycho-education . Dropout was 18 % ( 11/62 ) in AAF , mainly due to technical problems and poor usability of the accelerometer , and 38 % ( 21/55 ) in eMBCT , mainly due to the perceived high intensity of the program . Conclusions Both the AAF and eMBCT interventions are effective for managing fatigue severity compared to receiving psycho-educational emails . Trial Registration Trialregister.nl NTR3483 ; http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=3483 ( Archived by WebCite at http://www.webcitation.org/6NWZqon3o 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 r and omized 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 . Implication s for cancer survivorsThe 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 PURPOSE This study aim ed to determine the effect of individualized patient education along with emotional support on the quality of life ( QoL ) of breast cancer patients undergoing chemotherapy . It also aim ed to determine the intervention 's feasibility in the Pakistani context . METHODS A quasi-experimental design , with pre- and post-test , in two groups , via time block , was used . The study was conducted at a public hospital in Karachi with a sample of 50 patients ; 25 patients each in the intervention and control group . The intervention was delivered over a period of six weeks . It comprised verbal and written patient education , availability of a nurse during patients ' chemotherapy administration and over the telephone , and a telephone follow-up of the patients by the nurse . patients ' QoL was assessed at baseline and at the sixth week of receiving chemotherapy . RESULTS Tests indicated a significant improvement in the overall QoL , breast cancer subscale scores , and the physical and emotional well-being of the intervention group , as compared to the control group . The intervention effect size was moderate ( 0.655 ) for the QoL. CONCLUSION The intervention was found to be effective in improving patients ' QoL. However , a larger study , in a multi-center setting , is recommended to ascertain the findings of this pilot study Background Adding bevacizumab to chemotherapy improves response rates and progression-free survival ( PFS ) in metastatic breast cancer ( mBC ) . We aim ed to demonstrate decreased toxicity with metronomic chemotherapy/bevacizumab compared with paclitaxel/bevacizumab . Methods This multicenter , r and omized phase III trial compared bevacizumab with either paclitaxel ( arm A ) or daily oral capecitabine-cyclophosphamide ( arm B ) as first-line treatment in patients with HER2-negative advanced breast cancer . The primary endpoint was the incidence of selected grade 3–5 adverse events ( AE ) including : febrile neutropenia , infection , sensory/motor neuropathy , and mucositis . Secondary endpoints included objective response rate , disease control rate , PFS , overall survival ( OS ) , quality of life ( QoL ) , and pharmacoeconomics . The study was registered prospect ively with Clinical Trials.gov , number NCT01131195 on May 25 , 2010 . Results Between September 2010 and December 2012 , 147 patients were included at 22 centers . The incidence of primary endpoint-defining AEs was similar in arm A ( 25 % [ 18/71 ] ; 95 % CI 15–35 % ) and arm B ( 24 % [ 16/68 ] ; 95 % CI 13–34 % ; P = 0.96 ) . Objective response rates were 58 % ( 42/73 ; 95 % CI 0.46–0.69 ) and 50 % ( 37/74 ; 95 % CI 0.39–0.61 ) in arms A and B , respectively ( P = 0.45 ) . Median PFS was 10.3 months ( 95 % CI 8.7–11.3 ) in arm A and 8.5 months ( 95 % CI 6.5–11.9 ) in arm B ( P = 0.90 ) . Other secondary efficacy endpoints were not significantly different between study arms . The only statistically significant differences in QoL were less hair loss and less numbness in arm B. Treatment costs between the two arms were equivalent . Conclusion This trial failed to meet its primary endpoint of a reduced rate of prespecified grade 3–5 AEs with metronomic bevacizumab , cyclophosphamide and capecitabine Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE . Suboptimal adherence to self-administered medications is a common problem . The purpose of this study was to determine the effectiveness of a video-game intervention for improving adherence and other behavioral outcomes for adolescents and young adults with malignancies including acute leukemia , lymphoma , and soft-tissue sarcoma . METHODS . A r and omized trial with baseline and 1- and 3-month assessment s was conducted from 2004 to 2005 at 34 medical centers in the United States , Canada , and Australia . A total of 375 male and female patients who were 13 to 29 years old , had an initial or relapse diagnosis of a malignancy , and currently undergoing treatment and expected to continue treatment for at least 4 months from baseline assessment were r and omly assigned to the intervention or control group . The intervention was a video game that addressed issues of cancer treatment and care for teenagers and young adults . Outcome measures included adherence , self-efficacy , knowledge , control , stress , and quality of life . For patients who were prescribed prophylactic antibiotics  , adherence to trimethoprim-sulfamethoxazole was tracked by electronic pill-monitoring devices ( n = 200 ) . Adherence to 6-mercaptopurine was assessed through serum metabolite assays ( n = 54 ) . RESULTS . Adherence to trimethoprim-sulfamethoxazole and 6-mercaptopurine was greater in the intervention group . Self-efficacy and knowledge also increased in the intervention group compared with the control group . The intervention did not affect self-report measures of adherence , stress , control , or quality of life . CONCLUSIONS . The video-game intervention significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy . The findings support current efforts to develop effective video-game interventions for education and training in health care CONTEXT Many breast cancer patients have unmet informational and psychosocial needs after treatment completion . A psychoeducational intervention may be well suited to support these patients . OBJECTIVES The purpose of this multicenter r and omized controlled trial was to examine the effectiveness of a web-based tailored psychoeducational program ( ENCOURAGE ) for breast cancer patients , which aims to empower patients to take control over prevailing problems . METHODS Female breast cancer patients from two hospitals in The Netherl and s who recently completed (neo-)adjuvant chemotherapy were r and omly assigned to st and ard care or 12-week access to the ENCOURAGE program providing fully automated information problem-solving strategies , re sources , and services for reported problems . At six and 12 weeks , patients completed self-report questions on optimism and control over the future ( primary outcome ) , feelings of being informed , and acceptance of the illness . At baseline and 12 weeks , distress and quality of life question naires were completed . RESULTS About 138 patients were included . Almost all patients ( 67 of 69 ) visited ENCOURAGE as requested . No differences between the control and intervention group were observed for primary and secondary outcomes . An unplanned subgroup analysis showed that in clinical ly distressed patients ( N = 57 at baseline ; 41 % ) , use of the ENCOURAGE program increased optimism and control over the future at 12 weeks more than in patients in the control group ( Cohen 's d = 0.65 ) . CONCLUSION Although the effectiveness was not demonstrated , a subgroup of women treated for breast cancer can probably be supported by the program . The results of the present study are a starting point for further development and use of the program Background Being diagnosed with cancer causes major psychological distress , yet the majority of newly diagnosed cancer patients lack psychological support . Internet interventions overcome many barriers for seeking face-to-face support and allow for independence in time and place . We assess efficacy and feasibility of the first web-based stress management intervention ( STREAM : STREss-Aktiv-Mindern ) for newly diagnosed , German-speaking cancer patients . Methods / design In a prospect i ve , wait-list controlled trial 120 newly diagnosed cancer patients will be included within 12 weeks of starting anti-cancer treatment and r and omized between an immediate ( intervention group ) or delayed ( control group ) 8-week , web-based intervention . The intervention consists of eight modules with weekly written feedback by a psychologist ( “ minimal-contact ” ) based on well-established stress management manuals including downloadable audio-files and exercises . The aim of this study is to evaluate efficacy in terms of improvement in quality of life ( FACT-F ) , as well as decrease in anxiety and depression ( HADS ) , as compared to patients in the wait-list control group . A sample size of 120 patients allows demonstrating a clinical ly relevant difference of nine points in the FACT score after the intervention ( T2 ) with a two-sided alpha of 0.05 and 80 % power . As this is the first online stress management intervention for German-speaking cancer patients , more descriptive outcomes are equally important to further refine the group of patients with the largest potential for benefit who then will be targeted more specifically in future trials . These descriptive endpoints include : patients ’ characteristics ( type of cancer , type of treatment , socio-demographic factors ) , dropout rate and dropout reasons , adherence and satisfaction with the program . Discussion New technologies open new opportunities : minimal-contact psychological interventions are becoming st and ard of care in several psychological disorders , where their efficacy is often comparable to face-to-face interventions . With our study we open this field to the population of newly diagnosed cancer patients . We will not only assess clinical efficacy but also further refine the target population who has the most potential to benefit . An internet-based minimal-contact stress management program might be an attractive , time- and cost-effective way to effectively deliver psychological support to newly diagnosed cancer patients and an opportunity to include those who currently are not reached by conventional support . Trial registration Clinical Trials.gov NCT02289014 BACKGROUND Prostate cancer ( PCa ) poses many emotional and physical challenges for men following treatment . The unmet support needs of these men are well documented , and access to psychosocial support remains problematic . OBJECTIVES To assess the efficacy of an online psychological intervention for men who have localised PCa . DESIGN , SETTING , AND PARTICIPANTS We undertook a r and omised controlled trial to evaluate the intervention . Participants were r and omly allocated to one of three conditions :  My Road Ahead ( MRA ) alone ( MRA Only ) , MRA plus access to an online forum ( MRA+Forum ) , and access to the forum alone ( Forum ) . INTERVENTION The intervention was a 10-week self-guided online psychological intervention called My Road Ahead that consisted of six themed modules design ed to facilitate improved emotional well-being in the context of PCa as well as a moderated peer forum . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Pre- and postintervention assessment s of psychological distress ( the 21- question Depression , Anxiety and Stress Scale ) [ 1 ] and the Prostate Cancer-related Quality of Life scale [ 2 ] were conducted . Multivariate analysis of variance , regression , and structural equation modelling were used to analyse the data . RESULTS AND LIMITATIONS In total , 142 participants were r and omly allocated to one of the three intervention arms . The mean age of participants was 61 yr of age ( st and ard deviation : 7 ) , and 88 % had undergone radical prostatectomy . A significant improvement in psychological distress was observed for participants who had access to the combined condition ( MRA+Forum ) with a moderate effect size ( p=0.02 ; partial η(2)=0.07 ) . In particular , the decline in the mean level of psychological distress was 8.8 units larger for the MRA+Forum group than the Forum group ( 95 % confidence interval [ CI ] , 0.9 - 16.7 ) . Although the decline in the mean level of psychological distress was 7.0 units larger for the MRA+Forum group than for the MRA Only group , this difference was not significant ( 95 % CI , 1.1 - 15.1 ) . Structural equation modelling indicated that reductions in health worry and regret contributed significantly to the reductions in psychological distress for the MRA+Forum condition . CONCLUSIONS This study is the first , to our knowledge , that has evaluated a self-guided online psychological intervention tailored to the specific needs of men who have PCa . The findings of this study indicate the potential for this programme to deliver support that men may not otherwise receive . PATIENT SUMMARY This study found that men who have localised prostate cancer who received access to the online psychological intervention called My Road Ahead combined with the online peer discussion forum had significantly improved reductions in distress compared with those who received access to the online intervention alone or the forum alone Purpose This study evaluated the efficacy of a self-guided Web-based cognitive behaviour therapy ( CBT ) intervention compared to an attention control in improving cancer-related distress , health-related quality of life ( HRQOL ) , and maladaptive coping , among people recently diagnosed with cancer . Methods Sixty individuals with cancer diagnosed in the previous 6 months and receiving treatment with curative intent were r and omised to receive either the 6-week intervention Cancer Coping Online ( CCO : n = 30 ) or the 6-week Web-based attention control ( n = 30 ) . Outcome measures , including cancer distress ( the Posttraumatic Stress Scale — Self-Report ) , general distress ( Depression Anxiety Stress Scale ) , quality of life ( EORTC QLQ-C30 ) , and coping ( mini-MAC ) , were administered at baseline , immediately post-intervention , and at 3 and 6 months post-intervention . Results Significant main effects for time were found for cancer distress , global QOL , physical function , role function , social function , and anxious preoccupation . Post hoc between-group comparisons showed CCO participants had statistically significantly higher physical functioning compared to controls at 3 months of follow-up ( d = −0.52 , p = 0.02 ) . Furthermore , compared to controls , post hoc comparisons found moderate between-group effect sizes favouring CCO post-intervention for cancer distress ( d = 0.43 ) and anxious preoccupation ( d = 0.38 ) , and at 6 months of follow-up for global QOL ( d = −0.43 ) . Conclusions These results provide preliminary support for the potential efficacy of a self-guided Web-based CBT programme in improving aspects of HRQOL , cancer-related distress , and anxious preoccupation after cancer diagnosis . This paper provides justification for , and will help inform the development of , subsequent larger multi-site studies BACKGROUND Managing distress has become crucial in optimized cancer care . Psychoeducation using tablet PCs has potential as a novel intervention to reduce distress in cancer patients . We examined the benefit of a single-session psychoeducation using a tablet PC during chemotherapy . METHODS Thirty-six cancer patients with significant levels of distress , as determined by the Hospital Anxiety and Depression Scale ( HADS ) , enrolled from the chemotherapy unit in Seoul National University Cancer Hospital . Participants were quasi-r and omized into either the  intervention ( n = 19 ) or control ( n = 17 ) group . Twenty-minute-long psychoeducation on distress management was provided via tablet PCs during chemotherapy infusion . HADS , Short-form 8 Health Survey , MD And erson Symptom Inventory , Insomnia Severity Index , and Impact of Event Scale-Revised ( IES-R ) were administered at baseline and 3 weeks later . The use of psychosocial services was review ed 6 months later . RESULTS Compared with controls , the intervention group showed a superior 3-week clinical trajectory regarding the score changes of the HADS depression subscale ( U = 69.0 ; p = 0.006 ) , mental component summary score of the Short-form 8 Health Survey ( U = 75.5 ; p = 0.011 ) , Impact of Event Scale-Revised avoidance subscale ( U = 89.0 ; p = 0.036 ) , and Insomnia Severity Index total score ( U = 82.5 ; p = 0.021 ) . There was no significant between-group difference regarding the use of psychosocial services after 6 months . CONCLUSIONS A tablet PC-based psychoeducation during chemotherapy infusion could be an effective intervention on managing depression , sleep disturbance , and quality of life in cancer patients suffering from distress Many well- design ed studies have shown psychosocial treatments for cancer to be efficacious for improving patients ' quality of life , but the actual impact of these treatments may be limited by low rates of participation . Web-based treatment formats could improve effectiveness by increasing availability and accessibility . Two phases of a feasibility study are reported in this article . In the first phase , we sought to assess  internet access and perceived interest in online support among 136 women with breast cancer ( June-October , 1999 ) . Levels of interest in participating in an online psychosocial treatment were associated with age , outcome expectancy , and barriers to using the internet but not stage or time since diagnosis . In the second phase , we document accrual rates among several methods of recruitment during a r and omized trial ( February-December , 2001 ) and report changes over time in internet access . Recruitment rates were substantially higher when a study representative was available in clinic to provide information about the treatment than for all other methods of recruitment . Access to the internet increased between 1999 ( 63 % ) and 2001 ( 70 % ) and varied across age groups . These results suggest that internet-based psychosocial treatments , with notable limitations , are feasible for increasing the impact of psychosocial care Abstract Purpose : To provide a comprehensive review of psycho-educational interventions using telecommunication technologies developed for adult cancer patients , assessing their effectiveness in reducing emotional distress and improving quality of life ( QoL ) . Material s and methods : A narrative approach was used for extraction and synthesis of the data . Relevant studies were identified through the electronic data bases PubMed , Scopus , Web of Science , ProQuest , Psychology & Behavioral Sciences Collection ( through EBSCOhost ) , and CENTRAL . Results : Eight studies involving 1016 participants met inclusion criteria . The majority of the studies included ( n = 6 ) used a r and omized design and were published between 2007 and 2016 . Interventions used a variety of delivery re sources , such as telephone , e-mail and websites , but all were aim ing to respond to information needs and develop stress control skills . A trend toward reducing distress and improving QoL was found , but estimated effect sizes were typically small ( d < 0.5 ) . Telephonically delivered psycho-educational interventions presented the highest between-group effects on these outcomes during survival , but were limited by sample size . Conclusions : The efficacy of interventions using distance approaches in the cancer setting is still not well-established . Further research should be conducted through well- design ed studies with more interactive features that minimize the lack of face-to-face interaction . Implication s for rehabilitation Rehabilitation professionals working in the field of oncology should invest in the development of psycho-educational interventions responding the patients ’ educational needs and promoting their stress control skills . Programs using telecommunications technologies may reduce disparities in service delivery within this setting , minimizing geographic and socio-economic barriers to engagement in the interventions . With the current technological development , it is possible to perform more interactive interventions that stimulate therapist – patient interactions . However , available protocol s in this field still employ basic re sources ( e.g. , websites , e-mail , and videos ) . Young adult cancer patients are exposed to additional requirements related to fertility and parenthood . New intervention approaches should consider their informational needs The primary objectives of this research were to translate , vali date , and generate normative data on the SF-36 Health Survey for use among Dutch-speaking residents of the Netherl and s. Translation of the SF-36 into Dutch followed the stepwise , iterative procedures developed by the IQOLA Project . Following extensive pilot testing , the SF-36 was administered to : ( 1 ) a r and om sample of adult residents of Amsterdam ( n = 4172 ) ; ( 2 ) a r and om , nationwide sample of adults ( n = 1742 ) ; ( 3 ) a sample of migraine sufferers ( n = 423 ) ; and ( 4 ) a sample of cancer patients undergoing active anti-neoplastic treatment ( n = 485 ) .  Data quality across the four studies was consistently high . The rates of missing data ranged from 1 % to 5 % at the item level , and from 1.2 % to 2.6 % at the scale level . Multitrait scaling analysis confirmed the hypothesized scale structure of the SF-36 and associated scale scoring in all four sample s. Cronbach 's alpha coefficients surpassed the 0.70 criterion for group comparisons in all but one case ( the Social Functioning scale in the cancer sample ) , with a mean alpha coefficient across all scales and sample s of 0.84 . Known-group comparisons yielded consistent support for the validity of the SF-36 . In the two community sample s , statistically significant differences in SF-36 mean scale scores were observed as a function of age , gender , and the prevalence of chronic health conditions . In the migraine and cancer sample s , mean SF-36 scale scores varied significantly as a function of various indicators of disease severity . The SF-36 profiles for the two community sample s were highly similar . The cancer sample yielded the lowest SF-36 scores , with the migraine sample holding an intermediate position . On-going studies will generate data on the responsiveness of the SF-36 to within-group changes in health over time . Efforts are underway to translate and vali date the question naire for use among ethnic minority groups in the Netherl and Background : We conducted a r and omised study to investigate whether providing a self-guided Internet support group to cancer patients affected mood disturbance and adjustment to cancer . Methods : Baseline and 1- , 6- and 12-month assessment s were conducted from 2004 to 2006 at a national rehabilitation centre in Denmark . A total of 58 rehabilitation course weeks including 921 survivors of various cancers were r and omly assigned to a control or an intervention group by cluster r and omisation . The intervention was a lecture on the use of the Internet for support and information followed by participation in an Internet support group . Outcome measures included self-reported mood disturbance , adjustment to cancer and self-rated health . Differences in scores were compared between the control group and the intervention group . Results : The effect of the intervention on mood disturbance and adjustment to cancer showed a transient difference at the 6-month follow-up , where the intervention group reported less reduction in anxious preoccupation ( P=0.04 ) , helplessness ( P=0.002 ) , confusion ( P=0.001 ) and depression ( P=0.04 ) . Otherwise no significant effects were observed . Conclusion : We conclude that use of Internet-based support groups in cancer patients still needs to confirm long-lasting psychological effects PURPOSE To estimate prevalence and severity of patients ' self-perceived supportive care needs in the immediate post-treatment phase and identify predictors of unmet need . PATIENTS AND METHODS A multicenter , prospect i ve , longitudinal survey was conducted . Sixty-six centers recruited patients for 12 weeks . Patients receiving treatment for the following cancers were recruited : breast , prostate , colorectal , and gynecologic cancer and non-Hodgkin 's lymphoma . Measures of supportive care needs , anxiety and depression , fear of recurrence , and positive and negative affect were completed at the end of treatment ( T0 ) and 6 months later ( T1 ) . RESULTS Of 1,850 patients given question naire packs , 1,425 ( 79 % ) returned question naires at T0 , and 1,152 ( 62 % ) returned question naires at T1 . Mean age was 61 years ; and most respondents were female ( 69 % ) and had breast cancer ( 57 % ) . Most patients had no or few moderate or severe unmet supportive care needs . However , 30 % reported more than five unmet needs at baseline , and for 60 % of these patients , the situation did not improve . At both assessment s , the most frequently endorsed unmet needs were psychological needs and fear of recurrence . Logistic regression revealed several statistically significant predictors of unmet need , including receipt of hormone treatment , negative affect , and experiencing an unrelated significant event between assessment s. CONCLUSION Most patients do not express unmet needs for supportive care after treatment . Thirty percent reported more than five moderate or severe unmet needs at both assessment s. Unmet needs were predicted by hormone treatment , negative mood , and experiencing a significant event . Our results suggest that there is a proportion of survivors with unmet needs who might benefit from the targeted application of psychosocial re sources Objective To examine the evidence for the use of psychological and psychosocial interventions offered to forensic mental health in patients . Design CINAHL , MEDLINE , PsycINFO , ScienceDirect and Web of Science data bases were search ed for research published in English between 1 January 1990 and 31 May 2018 . Outcome measures Disturbance , mental well-being , quality of life , recovery , violence/risk , satisfaction , seclusion , symptoms , therapeutic relationship and ward environment . There were no limits on the length of follow-up . Eligibility criteria We included r and omised controlled trial ( RCT ) studies of any psychological or psychosocial intervention in an inpatient forensic setting . Pilot or feasibility studies were included if an RCT design was used . We restricted our search criteria to in patients in low , medium and high secure units aged over 18 . We focused on interventions considered applicable to most patients residing in forensic mental health setting s. Data extraction and synthesis Two independent review ers extracted data and assessed risk of bias . Results 17 232 citations were identified with 195 full manuscripts examined in detail . Nine papers were included in the review . The heterogeneity of the identified studies meant that meta- analysis was inappropriate . The results were presented in table form together with a narrative synthesis . Only 7 out of 91 comparisons revealed statistically significant results with no consistent significant findings . The most frequently reported outcomes were violence/risk and symptoms . 61 % of the violence/risk comparisons and 79 % of the symptom comparisons reported improvements in the intervention groups compared with the control groups . Conclusions Current practice is based on limited evidence with no consistent significant findings . This review suggests psychoeducational and psychosocial interventions did not reduce violence/risk , but there is tentative support they may improve symptoms . More RCTs are required with : larger sample sizes , representative population s , st and ardised outcomes and control group interventions similar in treatment intensity to the intervention . PROSPERO registration number CRD42017067099 Abstract Background : Although there are effective dermatological treatments for psoriasis , a proportion of individuals also experience psychological distress not addressed by these treatments . Psychological factors may be targeted by cognitive behavioral therapy ( CBT ) which may in turn also decrease psoriasis severity . Method : A systematic review using PsycINFO , PubMed , and SCOPUS data bases was performed in 2019 to examine the efficacy of treatments that delivered psychotherapy with a major cognitive/behavioral component to patients with psoriasis . Quality of included studies was assessed . Results : Nine r and omized controlled trials with 8 unique sample s met inclusion criteria . Study quality ranged from fair to good . Half of the studies found improved psoriasis severity following treatment . Several studies found improvements following treatment in anxiety , depression , and stress . The studies that reported non-significant findings on psychological outcomes had sample s with healthy baseline psychological functioning . Nearly all studies that examined quality of life as an outcome found improvements following treatment . Conclusion : CBT as an adjunct to conventional dermatological treatments may be particularly beneficial for individuals with more severe pretreatment psychopathology in improving psoriasis severity , anxiety , and depression symptoms .  CBT appears to be generally effective in improving quality of life . Greater method ological rigor is needed in future research
To systematic ally review evidence regarding the benefits of Internet-based psycho-educational interventions among cancer patients .