Finding My Way : results of a multicentre RCT evaluating a web-based self-guided psychosocial intervention for newly diagnosed cancer survivors

Supportive Care in Cancer(2018)

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摘要
Purpose This multicentre randomised controlled trial examined the efficacy of Finding My Way ( FMW ), a 6-week/6-module online self-guided psychotherapeutic intervention for newly diagnosed curatively treated cancer survivors, in reducing cancer-related distress and improving quality of life compared to an online attention control. Methods Participants were randomised on a 1:1 ratio using a gender-stratified block design to intervention ( n = 94) or attention control ( n = 97), and were blinded to condition. Assessments were completed at baseline (T0), post-intervention (T1), 3 months (T2), and 6 months (T3) post-intervention. Mixed model repeated measures analyses examined differences between groups for cancer-specific distress (primary outcome) and general distress, quality of life (QoL), coping, and health service utilisation (secondary outcomes). Results While both groups reported reduced cancer-specific and general distress over time, between-group differences were not significant. Intervention participants reported lower total health service utilisation and supportive care utilisation post-intervention than controls (total HS use: between-group mean difference = − 1.07 (− 1.85 to − 0.28); supportive care use: between-group mean difference = − 0.64 (− 1.21 to − 0.06)) and significantly higher emotional functioning at 3 months (between-group mean difference = 7.04 (0.15 to 13.9)). At 6 months, the supportive care utilisation finding reversed (between-group mean difference = 0.78 points (0.19 to 1.37). Across remaining QoL and coping outcomes, no significant group differences emerged. Conclusions While both groups experienced reductions in distress, between-group differences were not significant. This contrasts with the significantly improved emotional functioning observed in FMW participants at 3 months and the short-term reductions in health service utilisation. Long-term increases in supportive care service utilisation suggest FMW only met needs while being actively used. Trial registration ACTRN12613000001796; http://www.ANZCTR.org.au/ACTRN12613000001796.aspx
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关键词
Internet intervention,Self-guided,CBT,Distress,Acute survivorship,RCT
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