Short-Term Effectiveness of a Stepped-Care Model to Address Fear of Cancer Recurrence in Patients With Early-Stage Melanoma
- Author(s)
- Thompson, JR; Gomes, L; Kouvelis, G; Smith, AL; Lo, SN; Kasparian, NA; Saw, RPM; Dieng, M; Seaman, L; Martin, LK; Guitera, P; Milne, D; Schmid, H; Cust, AE; Bartula, I;
- Details
- Publication Year 2024-12,Volume 33,Issue #12,Page e70041
- Journal Title
- Psycho-Oncology
- Publication Type
- Research article
- 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).
- Publisher
- Wiley
- Keywords
- Humans; *Melanoma/psychology/therapy; Male; Female; Middle Aged; *Fear/psychology; *Neoplasm Recurrence, Local/psychology; Aged; *Quality of Life; *Anxiety/psychology/therapy; *Skin Neoplasms/psychology/therapy; Adult; *Depression/psychology/therapy; Telemedicine; Neoplasm Staging; Patient Education as Topic/methods; Stress, Psychological/therapy/psychology; cancer; fear of cancer recurrence; implementation; melanoma; oncology; psychological intervention; psycho‐oncology; screening; stepped‐care
- Department(s)
- Health Services Research
- Publisher's Version
- https://doi.org/10.1002/pon.70041
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-01-09 06:35:16
Last Modified: 2025-01-09 06:41:23