Short-Term Effectiveness of a Stepped-Care Model to Address Fear of Cancer Recurrence in Patients With Early-Stage Melanoma.

IF 3.3 2区医学 Q2 ONCOLOGY Psycho‐Oncology Pub Date : 2024-12-01 DOI:10.1002/pon.70041

Jake R Thompson, Lisa Gomes, Grace Kouvelis, Andrea L Smith, Serigne N Lo, Nadine A Kasparian, Robyn P M Saw, Mbathio Dieng, Linda Seaman, Linda K Martin, Pascale Guitera, Donna Milne, Helen Schmid, Anne E Cust, Iris Bartula

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Abstract

Objective: To investigate the effectiveness of the Melanoma Care Programme when implemented into routine clinical practice coupled with fear of cancer recurrence (FCR) screening and a stepped-care model of intervention delivery.

Methods: Using a Type-I hybrid effectiveness-implementation design, individuals with stage 0-II melanoma and a Fear of Cancer Recurrence Inventory FCR severity score of ≥ 13 were offered the Melanoma Care Programme. The programme included a psychoeducational booklet and 3 to 5 psychotherapeutic telehealth sessions with a clinical psychologist, timed around routine dermatological appointments. Multivariable linear mixed modelling was used to analyse the effect of the intervention at 1-week post-intervention on patient-reported outcomes, including FCR severity (primary outcome), symptoms of depression, anxiety, and stress, melanoma-related knowledge, and health-related quality of life.

Results: One hundred and twelve participants completed the intervention from 146 participants screened for FCR. Adjusted multivariable linear mixed modelling demonstrated that participants who received the intervention reported a reduced FCR severity at 1-week post-intervention (mean change: -3.81 [95% CI: -4.67, -2.95], p < 0.001) compared to baseline. Participants also reported improvements in melanoma-related knowledge (mean change: 0.64 [95% CI: 0.13, 1.15], p = 0.014), depressive symptoms (mean change: -1.41 [95% CI: -1.92, -0.90], p < 0.001), anxiety (mean change: -1.05 [95% CI: -1.48, -0.61], p < 0.001), stress (mean change: -1.58 [95% CI: -2.22, -0.93], p < 0.001), and health-related quality of life (mean change: 4.05 [95% CI: 2.84, 5.26], p < 0.001).

Conclusions: The Melanoma Care Programme maintained effectiveness when implemented into routine clinical practice with the addition of FCR screening and a stepped care model of delivery.

Trial registration: This study is registered with the Australia and New Zealand Clinical Trials Register (ACTRN12621000145808).

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解决早期黑色素瘤患者癌症复发恐惧的阶梯式护理模式的短期有效性。

目的：探讨黑色素瘤护理方案在常规临床实践中实施的有效性，并结合对癌症复发的恐惧（FCR）筛查和干预交付的分步护理模式。方法：采用i型混合有效性-实施设计，为0-II期黑色素瘤患者和癌症复发恐惧量表FCR严重程度评分≥13的个体提供黑色素瘤护理计划。该方案包括一本心理教育小册子和与一名临床心理学家进行的3至5次心理治疗远程保健会议，这些会议安排在例行皮肤科预约期间。多变量线性混合模型用于分析干预后1周干预对患者报告结局的影响，包括FCR严重程度（主要结局）、抑郁、焦虑和压力症状、黑色素瘤相关知识和健康相关生活质量。结果：从146名FCR筛查的参与者中，有112名参与者完成了干预。调整后的多变量线性混合模型显示，接受干预的参与者在干预后1周报告FCR严重程度降低（平均变化：-3.81 [95% CI: -4.67, -2.95], p）。结论：在常规临床实践中，通过增加FCR筛查和分步护理交付模式，黑色素瘤护理计划保持了有效性。试验注册：本研究已在澳大利亚和新西兰临床试验注册中心注册（ACTRN12621000145808）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

期刊介绍： Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.