Cocreated internet-based stepped care for individuals with cancer and concurrent symptoms of anxiety and depression : Results from the U-CARE AdultCan randomized controlled trial
| Autor: | Helena Igelström, Birgitta Johansson, Louise von Essen, Anna Hauffman, Susanne Mattsson, Marina Forslund, Peter Nygren, Sven Alfonsson, Anna Bill-Axelson, Leif Bergkvist |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_treatment Anxiety Hospital Anxiety and Depression Scale law.invention Stress Disorders Post-Traumatic 0302 clinical medicine Randomized controlled trial Quality of life law Neoplasms Medicine 030212 general & internal medicine technology-based interventions Depression (differential diagnoses) Depression Middle Aged anxiety Telemedicine Cognitive behavioral therapy Psychiatry and Mental health Treatment Outcome 030220 oncology & carcinogenesis Papers depression oncology Female medicine.symptom Paper Adult medicine.medical_specialty Randomization Experimental and Cognitive Psychology Nursing psychosocial intervention technology‐based interventions 03 medical and health sciences Psychoeducation Humans cancer Internet Cancer och onkologi Cognitive Behavioral Therapy business.industry Omvårdnad psycho‐oncology Cancer and Oncology randomized controlled trial Physical therapy Quality of Life psycho-oncology eHealth Self Report internet business |
| Zdroj: | Psycho-Oncology |
| Popis: | Objective The aim was to evaluate the effects of cocreated internet-based stepped care (iCAN-DO) on anxiety, depression, posttraumatic stress, and health-related quality of life (HRQoL) in individuals with cancer and self-reported anxiety and/or depression symptoms, compared with standard care. Methods Clinically recruited individuals with breast, colorectal, or prostate cancer underwent online screening with the Hospital Anxiety and Depression Scale (HADS). Those with anxiety and/or depression symptoms (>7 on any of the HADS subscales) were randomized to iCAN-DO or standard care. iCAN-DO comprised psychoeducation and self-care strategies (step 1) and internet-based cognitive behavioral therapy (iCBT, step 2). Data were collected before randomization and at 1, 4, 7, and 10 months and analyzed with intention-to-treat regression analysis and randomization tests. Results Online screening identified 245 (27%) of 909 individuals who reported anxiety and/or depression symptoms. They were randomized to iCAN-DO (n = 124) or standard care (n = 121). Of them 49% completed the 10-month assessment, and in the iCAN-DO group 85% accessed step 1 and 13% underwent iCBT. iCAN-DO decreased the levels of symptoms of depression (−0.54, 95% confidence interval: −1.08 to −0.01, P < .05) and the proportion of individuals with symptoms of depression (P < .01) at 10 months, compared with standard care, according to HADS. There were no significant effects on anxiety, posttraumatic stress, or HRQoL. Conclusion Internet-based stepped care improves symptoms of depression in individuals with cancer. Further studies are needed to gain knowledge on how to optimize and implement internet-based support in oncology care. |
| Databáze: | OpenAIRE |
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