Psychooncology. 2024 Dec;33(12):e70041. doi: 10.1002/pon.70041.
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).
PMID:39681994 | DOI:10.1002/pon.70041
