Sansom-Daly Ursula M, Wakefield Claire E, Bryant Richard A, Patterson Pandora, Anazodo Antoinette, Butow Phyllis, Sawyer Susan M, McGill Brittany C, Evans Holly E, Cohn Richard J
School of Women's and Children's Health, UNSW Sydney, Sydney, Australia.
Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.
Psychooncology. 2019 Feb;28(2):284-292. doi: 10.1002/pon.4938. Epub 2018 Nov 28.
Online psychological therapies provide a way to connect adolescent and young adult (AYA) cancer survivors to evidence-based support. We aimed to establish the feasibility, acceptability, and safety of Recapture life, a six-session group-based online cognitive-behavioural intervention, led by a facilitator, for AYAs in the early post-treatment period.
A randomised-controlled trial compared Recapture Life to an online peer-support group control and a waitlist control. Participants could nominate a support person. Acceptability was assessed using study opt-in and retention rates, participant-reported benefits/burdens of participation, and group facilitator burden. We also assessed the feasibility (eg, frequency/impact of technological difficulties) and psychological safety (ie, occurrence of clinically concerning distress) of the program.
Sixty-one participants took part (45 AYAs, 51.1% female; 19 support people). The opt-in rate was 30%, the enrolment rate was 87%, and 75% of participants took part in ≥5/6 sessions. AYAs reported high benefit and low burden of participation. Overall, 95 online group sessions were conducted; few required rescheduling by group facilitators (3%), but many took place outside of office hours (~90 hours). It took 40 days on average to create online groups, but established weekly sessions commenced quickly (M = 4.0 minutes). Technological difficulties were common but had a low impact on intervention delivery. Although 54% of AYAs returned a clinically concerning distress screen at some point, none reflected acute mental health risks.
The data largely indicate that Recapture Life is an acceptable, feasible, and safe model of evidence-based psychological support for AYAs during early survivorship, which nevertheless experienced common challenges in online/AYA intervention delivery.
在线心理治疗为青少年和青年癌症幸存者提供了一种获得循证支持的途径。我们旨在确定“重拾生活”（Recapture life）的可行性、可接受性和安全性。“重拾生活”是一种由主持人带领的、为期六节的基于小组的在线认知行为干预，针对处于治疗后早期的青少年和青年。
一项随机对照试验将“重拾生活”与在线同伴支持小组对照和等待名单对照进行了比较。参与者可以指定一名支持人员。通过研究参与率和留存率、参与者报告的参与益处/负担以及小组主持人负担来评估可接受性。我们还评估了该项目的可行性（例如，技术困难的频率/影响）和心理安全性（即临床相关困扰的发生情况）。
61名参与者（45名青少年和青年，51.1%为女性；19名支持人员）参与了研究。参与率为30%，入学率为87%，75%的参与者参加了≥5/6节课程。青少年和青年报告参与的益处高且负担低。总体而言，共进行了95次在线小组会议；很少需要小组主持人重新安排时间（3%），但许多会议在办公时间之外进行（约90小时）。创建在线小组平均需要40天，但既定的每周会议开始迅速（M = 4.0分钟）。技术困难很常见，但对干预实施的影响较小。尽管54%的青少年和青年在某个时间点返回了临床相关困扰筛查，但没有一个反映出急性心理健康风险。
数据在很大程度上表明，“重拾生活”是一种可接受、可行且安全的循证心理支持模式，适用于处于早期康复阶段的青少年和青年，不过在在线/青少年和青年干预实施过程中仍面临常见挑战。
