Abstract
Context
Advanced colorectal cancer and its treatment can bring about challenges associated
with psychological distress.
Objectives
The primary aims of this study were to examine the feasibility and acceptability of
a cognitive behavioral therapy (CBT)-based intervention to improve coping with the
disease. The secondary aim is to evaluate preliminary intervention efficacy.
Methods
Patients with advanced colorectal cancer in Singapore (N = 60) were randomized to either receive a four-session CBT intervention immediately
or be waitlisted. Intervention feasibility (i.e., recruitment and intervention adherence)
and acceptability (i.e., participant satisfaction and cultural sensitivity) were assessed.
Changes in psychological distress and self-efficacy were examined.
Results
The study successfully recruited the intended sample (mean age 61; 62% men). A proportion
(12%) reported Hospital Anxiety and Depression Scale scores indicative of distress
at baseline. Most (88%) completed all sessions. Participants reported high rates of
satisfaction (97%), helpfulness (96%), and cultural sensitivity (95%) of the intervention.
The intervention group did not show decrease in psychological distress; however, self-efficacy
in cancer-related coping (information seeking: effect size [ES] = 0.64; 95% CI = 0.17,
0.85; coping with side effects: ES = 0.69; 95% CI = 0.33, 0.82; and maintaining positive
attitude: ES = 0.45; 95% CI = 0.19, 0.79) increased in the intervention group compared
with the waitlisted group.
Conclusion
The CBT-based intervention was feasible and acceptable to patients in Singapore. There
is no sufficient evidence to warrant a larger trial in this sample with low baseline
distress. Future work should identify and target those who are most in need of support.
Key Words
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References
- 50 years of cancer registration: Singapore cancer registry appendices.Office NRoD, Singapore2014
- Comparing cancer experiences among people with colorectal cancer: a qualitative study.J Adv Nurs. 2011; 67: 2686-2695
- Coping with common stoma problems in care homes.Nurs Residential Care. 2011; 13: 126-128
- Quality of life of Danish colorectal cancer patients with and without a stoma.Support Care Cancer. 2007; 15: 505-513
- A systematic review of cognitive behavioral interventions in advanced cancer.Patient Educ Couns. 2012; 89: 15-24
- Psychosocial interventions for advanced cancer patients: a systematic review.Psychooncology. 2019; 28: 1394-1407
- Cognitive behaviour therapy for people with cancer.Oxford University Press, Oxford2002
- Randomized clinical trial of the effectiveness of a psychoeducational intervention in combating a symptom cluster in patients with advanced lung cancer.Oncol Nurs Forum. 2007; 34: 217-218
- A feasible and acceptable multicultural psychosocial intervention targeting symptom management in the context of advanced breast cancer.Psychooncology. 2019; 29: 389-397
- The effect of progressive muscle relaxation training on anxiety and quality of life after stoma surgery in colorectal cancer patients.Psychooncology. 2003; 12: 254-266
- A structural model of the relationships among self-efficacy, psychological adjustment, and physical condition in Japanese advanced cancer patients.Psychooncology. 2002; 11: 221-229
- Pilot trial of a STOMA psychosocial intervention programme for colorectal cancer patients with stomas.J Adv Nurs. 2019; 75: 1338-1346
- The effectiveness of a self-efficacy-enhancing intervention for Chinese patients with colorectal cancer: a randomized controlled trial with 6-month follow up.Int J Nurs Stud. 2014; 51: 1083-1092
- Randomized phase II clinical trials.Cancer Treat Rep. 1985; 69: 1375-1381
- Homework assignments in cognitive and behavioral therapy: a meta-analysis.Clin Psychol Sci Pract. 2000; 7: 189-202
- Therapist skill and patient variables in homework compliance: controlling an uncontrolled variable in cognitive therapy outcome research.Cogn Ther Res. 1999; 23: 381-399
- The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome.Eval Program Plann. 1982; 5: 233-237
- Cultural sensitivity and readability of breast and prostate printed cancer education materials targeting African Americans.J Natl Med Assoc. 1998; 90: 165
- The hospital anxiety and depression scale.Acta Psychiatr Scand. 1983; 67: 361-370
- Validation of the emotion thermometers and hospital anxiety and depression scales in Singapore: screening cancer patients for distress, anxiety and depression.Asia-Pacific J Clin Oncol. 2016; 12: e241-e249
- Self-efficacy for coping with cancer: revision of the Cancer Behavior Inventory (version 2.0).Psychooncology. 2001; 10: 206-217
- The validity of the Hospital Anxiety and Depression Scale: an updated literature review.J Psychosom Res. 2002; 52: 69-77
- The HADS and the DT for screening psychosocial distress of cancer patients in Taiwan.Psychooncology. 2011; 20: 639-646
- Pilot randomized phase II trial of the enhancing quality of life in patients (EQUIP) intervention for patients with advanced lung cancer.Am J Hosp Palliat Care. 2018; 35: 1050-1056
- Stigma towards people with mental illness in developing countries in Asia.Int Rev Psychiatry. 2007; 19: 157-178
- Willingness to participate in clinical trials among patients of Chinese heritage: a meta-synthesis.PLoS One. 2013; 8: e51328
- Coping skills training and acceptance and commitment therapy for symptom management: feasibility and acceptability of a brief telephone-delivered protocol for patients with advanced cancer.J Pain Symptom Manage. 2019; 59: 270-278
- A pilot study of a mobile health pain coping skills training protocol for patients with persistent cancer pain.J Pain Symptom Manage. 2015; 50: 553-558
- Establishing the minimal clinically important difference for the hospital anxiety and depression scale in patients with cardiovascular disease.J Cardiopulm Rehabil Prev. 2019; 39: E6-E11
- Study protocol of the CORRECT multicenter trial: the efficacy of blended cognitive behavioral therapy for reducing psychological distress in colorectal cancer survivors.BMC Cancer. 2018; 18: 748
- A systematic review of psychosocial interventions for colorectal cancer patients.Support Care Cancer. 2017; 25: 2349
- Feasibility, acceptability, and preliminary efficacy of a technology-assisted psychosocial intervention for racially diverse men with advanced prostate cancer.Cancer. 2015; 121: 4407-4415
- Psycho-oncology.Oxford University Press, New York2010
Article info
Publication history
Published online: June 20, 2020
Accepted:
June 12,
2020
Identification
Copyright
© 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
