Web-based stress management for newly diagnosed cancer patients (STREAM-1): a randomized, wait-list controlled intervention study

LBA10002 The full, final text of this abstract will be available at abstracts.asco.org at 2:00 PM (EDT) on Friday, June 2, 2017, and in the Annual Meeting Proceedings online supplement to the June 20, 2017, issue of the Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Saturday edition of ASCO Daily News.

Download Full-text

Web-based stress management for newly diagnosed cancer patients (STREAM): A randomized, wait-list controlled intervention study.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.18_suppl.lba10002 ◽

2017 ◽

Vol 35 (18_suppl) ◽

pp. LBA10002-LBA10002 ◽

Cited By ~ 2

Author(s):

Viviane Hess ◽

Astrid Grossert ◽

Judith Alder ◽

Sandra Scherer ◽

Barbara Handschin ◽

...

Keyword(s):

Stress Management ◽

Cancer Patients ◽

Controlled Trial ◽

Intervention Group ◽

Management Program ◽

Control Group ◽

Wait List ◽

Newly Diagnosed ◽

Web Based ◽

Minimal Contact

LBA10002 Background: Being diagnosed with cancer causes major distress, yet the majority of newly diagnosed cancer patients (pts) lack psychological support. Internet interventions overcome many barriers for seeking support. We assess efficacy and feasibility of a web-based minimal-contact stress management intervention (STREAM) for newly diagnosed cancer pts. Methods: In a prospective, wait-list controlled trial, newly diagnosed cancer pts were randomized within 12 weeks of starting anti-cancer treatment to an immediate or delayed (control group) 8-week, web-based intervention. The intervention consisted of 8 modules with weekly written feedback by a psychologist (“minimal-contact”) based on well-established stress management manuals. The aim of this study was to evaluate efficacy in terms of improvement in QoL (FACIT-F), decrease in distress (DT), anxiety/depression (HADS), as compared to pts in the wait-list group. 120 pts were needed to show (80% power, 2-sided α of 0.05) a clinically meaningful difference of ≥ 9 in FACT score after the immediate intervention (week 8 = T2). Results: 225 pts applied online. 128 pts were randomized. Median age was 52 (22-77)y. 108 (84%) were female. The majority of pts were treated in the curative setting (117pts; 91%), with chemotherapy (74 pts; 58%), for breast cancer (91pts; 71%). Self-reported distress at baseline ( = stratification factor) was above 4 on a 10-point scale (DT) with 96 pts (75%). At T2, QoL (FACIT-F) was sign. increased (p = 0.044; ANCOVA adjusted for baseline-distress) and distress sign. lowered (p = 0.032) in the intervention group as compared to the wait-list control. Median score (lower/upper quartile) for FACIT-F at baseline/T2 was 101.0(80.8/120)/119.0(98.0/132) and 108.3(87.8/124.0) /109.5(97.2/121.0); of DT at baseline/T2 was 6(5/8)/4(3/6) and 6(5/8)/6(4/7) for the intervention and control group, respectively. Decrease in HADS was not sign. different between the groups (p = 0.273). Conclusions: With STREAM, we open the field of minimal-contact online interventions to newly diagnosed cancer pts and show that an 8-week web-based stress management program is feasible and effective in improving QoL and distress. Clinical trial information: NCT02289014.

Download Full-text

Evaluation of My Stress Control, a web-based stress management program for persons experiencing work-related stress: A randomized controlled trial (Preprint)

10.2196/preprints.17314 ◽

2019 ◽

Author(s):

Caroline Eklund ◽

Anne Söderlund ◽

Magnus L Elfström

Keyword(s):

Randomized Controlled Trial ◽

Stress Management ◽

Perceived Stress ◽

Controlled Trial ◽

Intervention Group ◽

Wait List ◽

Post Intervention ◽

Web Based ◽

Stress Control ◽

Randomized Controlled

BACKGROUND Stress is one of the most common reasons for sick leave. Web-based interventions have the potential to reach an unlimited number of users at a low cost and have been shown effective at addressing several health-related problems. To handle stress on an individual level is about behavior change. To support behavior change in stress management My Stress Control (MSC) was developed. The development of MSC was based on several health psychology theories and models but central in the development was Social Cognitive Theory, Theory of Reasoned Action, Theory of Planned Behavior, Transactional Theory of Stress and Coping and the Transtheoretical Model and Stages of Change. MSC is a fully automated program. The program is tailored to the user's specific need for stress management and behavior change. OBJECTIVE The aim of this study was to conduct a randomized controlled trial to evaluate the extent to which MSC affected perceived stress in persons experiencing work-related stress. METHODS This study was conducted as a randomized controlled trial with two arms. Study participants were recruited by visiting worksites and workplace meetings. Participants were assigned to intervention or wait list group. Web-based questionnaires were used pre- and post-intervention to collect data. Perceived stress measured with the Perceived Stress Scale (PSS-14) was the primary outcome measurement. Analyses were conducted for both between- and within-group changes. RESULTS A total of 92 participants were included in this study, 48 in intervention group and 44 in waitlist group. Twelve participants in the intervention group and 19 participants in the waitlist group completed the post intervention assessment. There were no significant effects on perceived stress between the intervention and wait list groups or within the groups. A small effect size (dCohen=0.25) was found when comparing mean change over time on the primary outcome measure between the intervention and wait list groups. Additionally, a small effect size was found between pre- and post-intervention assessment within the intervention group (dCohen=0.38) as well as within the wait list group (dCohen=0.25). CONCLUSIONS It is still uncertain what effect My Stress Control (MSC) may have on perceived stress. Because adherence was low in the intervention group, elements or features that facilitate adherence must be further developed before firmer conclusions of the effect of MSC can be studied. CLINICALTRIAL This RCT was registered at clinicaltrials.gov, protocol record 2015/0646.

Download Full-text

Web-Based Stress Management for Newly Diagnosed Patients With Cancer (STREAM): A Randomized, Wait-List Controlled Intervention Study

Journal of Clinical Oncology ◽

10.1200/jco.2017.74.8491 ◽

2018 ◽

Vol 36 (8) ◽

pp. 780-788 ◽

Cited By ~ 26

Author(s):

Corinne Urech ◽

Astrid Grossert ◽

Judith Alder ◽

Sandra Scherer ◽

Barbara Handschin ◽

...

Keyword(s):

Quality Of Life ◽

Stress Management ◽

Depression Scale ◽

Anxiety And Depression ◽

Newly Diagnosed ◽

Hospital Anxiety ◽

Web Based ◽

Patients With Cancer ◽

Chronic Illness Therapy

Purpose Being diagnosed with cancer causes major psychological distress; however, a majority of patients lack psychological support during this critical period. Internet interventions help patients overcome many barriers to seeking face-to-face support and may thus close this gap. We assessed feasibility and efficacy of Web-based stress management (STREAM [Stress-Aktiv-Mindern]) for newly diagnosed patients with cancer. Patients and Methods In a randomized controlled trial, patients with cancer who had started first-line treatment within the previous 12 weeks were randomly assigned to a therapist-guided Web-based intervention or a wait-list (control), stratified according to distress level (≥ 5 v < 5 on scale of 0 to 10). Primary efficacy end point was quality of life after the intervention (Functional Assessment of Chronic Illness Therapy–Fatigue). Secondary end points included distress (Distress Thermometer) and anxiety or depression (Hospital Anxiety and Depression Scale). Treatment effect was assessed with analyses of covariance, adjusted for baseline distress. Results A total of 222 of 229 screened patients applied online for participation. Between September 2014 and November 2016, 129 newly diagnosed patients with cancer, including 92 women treated for breast cancer, were randomly assigned to the intervention (n = 65) or control (n = 64) group. Adherence was good, with 80.0% of patients using ≥ six of eight modules. Psychologists spent 13.3 minutes per week (interquartile range, 9.5-17.9 minutes per week) per patient for online guidance. After the intervention, quality of life was significantly higher (Functional Assessment of Chronic Illness Therapy–Fatigue: mean, 8.59 points; 95% CI, 2.45 to 14.73 points; P = .007) and distress significantly lower (Distress Thermometer: mean, −0.85; 95% CI, −1.60 to −0.10; P = .03) in the intervention group as compared with the control. Changes in anxiety or depression were not significant in the intention-to-treat population (Hospital Anxiety and Depression Scale: mean, −1.28; 95% CI, −3.02 to 0.45; P = .15). Quality of life increased in the control group with the delayed intervention. Conclusion The Web-based stress management program STREAM is feasible and effective in improving quality of life.

Download Full-text