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

Urech, Corinne and Grossert, Astrid and Alder, Judith and Scherer, Sandra and Handschin, Barbara and Kasenda, Benjamin and Borislavova, Borislava and Degen, Sven and Erb, Jennifer and Faessler, Alexandra and Gattlen, Laura and Schibli, Sarah and Werndli, Celine and Gaab, Jens and Berger, Thomas and Zumbrunn, Thomas and Hess, Viviane. (2018) Web-Based Stress Management for Newly Diagnosed Patients With Cancer (STREAM): A Randomized, Wait-List Controlled Intervention Study. Journal of clinical oncology, 36 (8). pp. 780-788.

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PurposeBeing 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 MethodsIn 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.ResultsA 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.ConclusionThe Web-based stress management program STREAM is feasible and effective in improving quality of life. (C) 2018 by American Society of Clinical Oncology.
Faculties and Departments:07 Faculty of Psychology > Departement Psychologie > Ehemalige Einheiten Psychologie > Abteilung Clinical Child and Adolescent Psychology
07 Faculty of Psychology > Departement Psychologie > Health & Intervention > Klinische Psychologie und Psychotherapie (Gaab)
UniBasel Contributors:Gaab, Jens
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:American Society of Clinical Oncology
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:10 Jan 2019 13:56
Deposited On:10 Jan 2019 13:56

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