Kinner Ellen M, Armer Jessica S, McGregor Bonnie A, Duffecy Jennifer, Leighton Susan, Corden Marya E, Gauthier Mullady Janine, Penedo Frank J, Lutgendorf Susan K
Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States.
Orion Center for Integrative Medicine, Seattle, WA, United States.
JMIR Cancer. 2018 Jan 15;4(1):e1. doi: 10.2196/cancer.8430.
Development of psychosocial group interventions for ovarian cancer survivors has been limited. Drawing from elements of cognitive-behavioral stress management (CBSM), mindfulness-based stress reduction (MBSR), and acceptance and commitment therapy (ACT), we developed and conducted preliminary testing of an Internet-based group intervention tailored specifically to meet the needs of ovarian cancer survivors. The Internet-based platform facilitated home delivery of the psychosocial intervention to a group of cancer survivors for whom attending face-to-face programs could be difficult given their physical limitations and the small number of ovarian cancer survivors at any one treatment site.
The aim of this study was to develop, optimize, and assess the usability, acceptability, feasibility, and preliminary intended effects of an Internet-based group stress management intervention for ovarian cancer survivors delivered via a tablet or laptop.
In total, 9 ovarian cancer survivors provided feedback during usability testing. Subsequently, 19 survivors participated in 5 waves of field testing of the 10-week group intervention led by 2 psychologists. The group met weekly for 2 hours via an Internet-based videoconference platform. Structured interviews and weekly evaluations were used to elicit feedback on the website and intervention content. Before and after the intervention, measures of mood, quality of life (QOL), perceived stress, sleep, and social support were administered. Paired t tests were used to examine changes in psychosocial measures over time.
Usability results indicated that participants (n=9) performed basic tablet functions quickly with no errors and performed website functions easily with a low frequency of errors. In the field trial (n=19), across 5 groups, the 10-week intervention was well attended. Perceived stress (P=.03) and ovarian cancer-specific QOL (P=.01) both improved significantly during the course of the intervention. Trends toward decreased distress (P=.18) and greater physical (P=.05) and functional well-being (P=.06) were also observed. Qualitative interviews revealed that the most common obstacles participants experienced were technical issues and the time commitment for practicing the techniques taught in the program. Participants reported that the intervention helped them to overcome a sense of isolation and that they appreciated the ability to participate at home.
An Internet-based group intervention tailored specifically for ovarian cancer survivors is highly usable and acceptable with moderate levels of feasibility. Preliminary psychosocial outcomes indicate decreases in perceived stress and improvements in ovarian cancer-specific QOL following the intervention. A randomized clinical trial is needed to demonstrate the efficacy of this promising intervention for ovarian cancer survivors.
针对卵巢癌幸存者的心理社会群体干预措施的发展一直有限。我们借鉴认知行为压力管理（CBSM）、基于正念的减压（MBSR）和接纳与承诺疗法（ACT）的要素，开发并开展了一项专门针对满足卵巢癌幸存者需求的基于互联网的群体干预的初步测试。基于互联网的平台便于将心理社会干预措施提供给一群癌症幸存者，鉴于他们的身体限制以及任一治疗地点卵巢癌幸存者数量较少，这些幸存者参加面对面项目可能会很困难。
本研究的目的是开发、优化并评估通过平板电脑或笔记本电脑为卵巢癌幸存者提供的基于互联网的群体压力管理干预措施的可用性、可接受性、可行性和初步预期效果。
共有9名卵巢癌幸存者在可用性测试期间提供了反馈。随后，19名幸存者参加了由2名心理学家主导的为期10周的群体干预的5轮现场测试。该群体通过基于互联网的视频会议平台每周会面2小时。采用结构化访谈和每周评估来收集对网站和干预内容的反馈。在干预前后，对情绪状态、生活质量（QOL）、感知压力、睡眠和社会支持进行测量。使用配对t检验来检验心理社会指标随时间的变化。
可用性结果表明，参与者（n = 9）能快速执行基本的平板电脑功能且无错误，能轻松执行网站功能且错误频率较低。在现场试验（n = 19）中，在5个小组中，为期10周的干预参与度良好。在干预过程中，感知压力（P = 0.03）和卵巢癌特异性生活质量（P = 0.01）均显著改善。还观察到痛苦程度降低（P = 0.18）以及身体（P = 0.05）和功能幸福感增强（P = 0.06）的趋势。定性访谈显示，参与者遇到的最常见障碍是技术问题以及练习项目中所教授技巧的时间投入。参与者报告称，该干预帮助他们克服了孤独感，并且他们很感激能够在家中参与。
专门为卵巢癌幸存者量身定制的基于互联网的群体干预具有高度可用性和可接受性，可行性处于中等水平。初步心理社会结果表明，干预后感知压力降低，卵巢癌特异性生活质量得到改善。需要进行一项随机临床试验来证明这种有前景的干预措施对卵巢癌幸存者的疗效。
