Project period
2015–2024
Funding
The Norwegian Cancer Society (Kreftforeningen #4602492) and Oslo University Hospital
Project summary
A cancer diagnosis and subsequent treatment can be disruptive and traumatic, often accompanied by a multitude of stressors for the patients. Uncertainty of outcome and invasive medical procedures with aversive side effects are not uncommon, and while people differ widely in how they experience and cope with such challenges, cancer related stress and distress including anxiety, depression, worry and rumination is common and prevalent.
Psychosocial interventions in cancer can be of support in such situations, facilitating psychological support and adaptation, including reducing distress, anxiety, negative affect and depression, as well as improving quality of life. Unfortunately, such in-person interventions are not always offered or accessible.
This study, conducted by the Department of Digital Health Research at Oslo University Hospital, combined well-established stress-management concepts for cancer survivors with cutting edge technology, creating an innovative application (app)-based cognitive behavioral stress-management intervention for cancer patients in Norway.
In phase I (2015/2017), the intervention was designed, developed, tailored and feasibility piloted by specialists in psychosocial oncology, stress management and eHealth, in close collaboration with patients with cancer and related health care personnel. The phase resulted in StressProffen™©, an evidence-based digital stress-management program with 10 cognitive behavioral based modules, including educational material, coping strategies and related stress-management techniques. The program was designed for both Android and IOS (Apple), and can be used through smart phones as well as tablets.
In phase II (2017/2020), the effect of the StressProffen™© intervention was tested with repeated measures in a randomized controlled trial (RCT), examining impact on stress, symptoms of anxiety and depression, self-regulatory capacity and health related quality of life. Participants were cancer survivors (N=172) in Norway diagnosed with various types of cancer and randomized to either the intervention (n=84) or to standard care (n=88).
Participants in the intervention group received: a) one in-person introduction-session, b) the StressProffen™© program, and c) two follow-up phone calls to see how things were going and if there were any questions. Participants were mainly female (82%), mean age 52 (range 20-78), with a variety of cancer types (majority breast cancer; 48%).
Findings showed how the group with access to StressProffen™© over 12 months, had a statistically significant reduction in perceived stress (p<.001), reduction in symptoms of depression (p=.003), improvement in capacity for self-regulation (i.e., capacity to regulate own thoughts, feelings and behavior) (p=.002), and improvement in a number of quality-of-life-related areas (6/8 areas p≤ .015), compared to the control group. The largest effect was observed at 6 months, then also with a statistically significant reduction in anxiety for those who had access to StressProffen™©.
The study showed how digital stress-management interventions such as StressProffen have the potential to extend outreach of psychological interventions and provide easily available, effective psychosocial support for cancer survivors.
So far, StressProffen™© is available in Norwegian and English versions. The program has great potential, and new studies examining StressProffen with additional patient groups, students, health care providers and other potential target groups are currently in progress.
