Suzanne C Danhauer, Gretchen A Brenes, Kathryn E Weaver, Emily V Dressler, Grace Westcott, Zhang Zhang, Lingyi Lu, Cheyenne R Wagi, Rakhee Vaidya, Amarinthia Curtis, Pamala A Pawloski, Sara Adams, Glenn J Lesser, Janet A Tooze
{"title":"社区癌症诊所对癌症治疗后幸存者抑郁和焦虑的步进式远程医疗干预的多站点可行性研究（WF-30917CD）。","authors":"Suzanne C Danhauer, Gretchen A Brenes, Kathryn E Weaver, Emily V Dressler, Grace Westcott, Zhang Zhang, Lingyi Lu, Cheyenne R Wagi, Rakhee Vaidya, Amarinthia Curtis, Pamala A Pawloski, Sara Adams, Glenn J Lesser, Janet A Tooze","doi":"10.1007/s11764-024-01721-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This feasibility study estimated accrual, retention, adherence, and summarized preliminary efficacy data from a stepped-care telehealth intervention for cancer survivors with moderate or severe levels of anxiety and/or depressive symptoms.</p><p><strong>Methods: </strong>Participants were randomized to intervention or enhanced usual care (stratified by symptom severity). In the intervention group, those with moderate symptoms received a cognitive-behavioral therapy (CBT) workbook/6 bi-weekly check-in calls (low intensity) and severe symptoms received the workbook/12 weekly therapy sessions (high intensity). Depression, anxiety, insomnia, fatigue, quality of life (QOL), fear of recurrence, and cancer-related distress were assessed pre- and post-intervention.</p><p><strong>Results: </strong>Participants (N = 68; ages 36-82; 88% White) were randomized to telehealth (n = 34) or enhanced usual care (EUC, n = 34), stratified by symptoms (moderate, n = 38; severe, n = 30). Accrual was 1.8/month with 88% retention and > 75% adherence. For those with moderate symptoms, the low-intensity intervention was associated with better cancer-related distress post-intervention but worse fatigue, insomnia, and physical QOL and and minimal differences for anxiety, depression, fear of recurrence, and mental QOL compared with EUC using clinically meaningful values to assess differences. For those with severe symptoms, the high-intensity intervention was associated with better fatigue, fear of recurrence, cancer-related distress, and physical/mental QOL.</p><p><strong>Conclusions: </strong>Accrual to a stepped-care telehealth intervention for distressed cancer survivors was lower than expected, but retention and adherence were strong. Data suggest potential impact of the high-intensity intervention.</p><p><strong>Implications for cancer survivors: </strong>A telephone-based CBT intervention where cancer survivors worked with a therapist yielded improvements in fatigue, fear of recurrence, distress, and quality of life.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A multi-site feasibility study of a stepped-care telehealth intervention for depression and anxiety in post-treatment cancer survivors at community cancer clinics (WF-30917CD).\",\"authors\":\"Suzanne C Danhauer, Gretchen A Brenes, Kathryn E Weaver, Emily V Dressler, Grace Westcott, Zhang Zhang, Lingyi Lu, Cheyenne R Wagi, Rakhee Vaidya, Amarinthia Curtis, Pamala A Pawloski, Sara Adams, Glenn J Lesser, Janet A Tooze\",\"doi\":\"10.1007/s11764-024-01721-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This feasibility study estimated accrual, retention, adherence, and summarized preliminary efficacy data from a stepped-care telehealth intervention for cancer survivors with moderate or severe levels of anxiety and/or depressive symptoms.</p><p><strong>Methods: </strong>Participants were randomized to intervention or enhanced usual care (stratified by symptom severity). In the intervention group, those with moderate symptoms received a cognitive-behavioral therapy (CBT) workbook/6 bi-weekly check-in calls (low intensity) and severe symptoms received the workbook/12 weekly therapy sessions (high intensity). Depression, anxiety, insomnia, fatigue, quality of life (QOL), fear of recurrence, and cancer-related distress were assessed pre- and post-intervention.</p><p><strong>Results: </strong>Participants (N = 68; ages 36-82; 88% White) were randomized to telehealth (n = 34) or enhanced usual care (EUC, n = 34), stratified by symptoms (moderate, n = 38; severe, n = 30). Accrual was 1.8/month with 88% retention and > 75% adherence. For those with moderate symptoms, the low-intensity intervention was associated with better cancer-related distress post-intervention but worse fatigue, insomnia, and physical QOL and and minimal differences for anxiety, depression, fear of recurrence, and mental QOL compared with EUC using clinically meaningful values to assess differences. For those with severe symptoms, the high-intensity intervention was associated with better fatigue, fear of recurrence, cancer-related distress, and physical/mental QOL.</p><p><strong>Conclusions: </strong>Accrual to a stepped-care telehealth intervention for distressed cancer survivors was lower than expected, but retention and adherence were strong. Data suggest potential impact of the high-intensity intervention.</p><p><strong>Implications for cancer survivors: </strong>A telephone-based CBT intervention where cancer survivors worked with a therapist yielded improvements in fatigue, fear of recurrence, distress, and quality of life.</p>\",\"PeriodicalId\":15284,\"journal\":{\"name\":\"Journal of Cancer Survivorship\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-01-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cancer Survivorship\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11764-024-01721-0\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cancer Survivorship","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11764-024-01721-0","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
A multi-site feasibility study of a stepped-care telehealth intervention for depression and anxiety in post-treatment cancer survivors at community cancer clinics (WF-30917CD).
Purpose: This feasibility study estimated accrual, retention, adherence, and summarized preliminary efficacy data from a stepped-care telehealth intervention for cancer survivors with moderate or severe levels of anxiety and/or depressive symptoms.
Methods: Participants were randomized to intervention or enhanced usual care (stratified by symptom severity). In the intervention group, those with moderate symptoms received a cognitive-behavioral therapy (CBT) workbook/6 bi-weekly check-in calls (low intensity) and severe symptoms received the workbook/12 weekly therapy sessions (high intensity). Depression, anxiety, insomnia, fatigue, quality of life (QOL), fear of recurrence, and cancer-related distress were assessed pre- and post-intervention.
Results: Participants (N = 68; ages 36-82; 88% White) were randomized to telehealth (n = 34) or enhanced usual care (EUC, n = 34), stratified by symptoms (moderate, n = 38; severe, n = 30). Accrual was 1.8/month with 88% retention and > 75% adherence. For those with moderate symptoms, the low-intensity intervention was associated with better cancer-related distress post-intervention but worse fatigue, insomnia, and physical QOL and and minimal differences for anxiety, depression, fear of recurrence, and mental QOL compared with EUC using clinically meaningful values to assess differences. For those with severe symptoms, the high-intensity intervention was associated with better fatigue, fear of recurrence, cancer-related distress, and physical/mental QOL.
Conclusions: Accrual to a stepped-care telehealth intervention for distressed cancer survivors was lower than expected, but retention and adherence were strong. Data suggest potential impact of the high-intensity intervention.
Implications for cancer survivors: A telephone-based CBT intervention where cancer survivors worked with a therapist yielded improvements in fatigue, fear of recurrence, distress, and quality of life.
期刊介绍：
Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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