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Sökning: onr:"swepub:oai:DiVA.org:uu-408909" > Internet-based Psyc...

Internet-based Psychosocial Support Design, Effects and User Experience in the Cancer Setting

Hauffman, Anna, (författare)
Uppsala universitet, Experimentell och klinisk onkologi
Johansson, Birgitta, 1959- (preses)
Uppsala universitet, Experimentell och klinisk onkologi, Uppsala universitet, Vårdvetenskap
Nygren, Peter, (preses)
Uppsala universitet, Experimentell och klinisk onkologi, Uppsala universitet, Cancerfarmakologi och beräkningsmedicin, Uppsala universitet, Science for Life Laboratory, SciLifeLab
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Igelström, Helena, 1976- (preses)
Uppsala universitet, Livsstil och rehabilitering vid långvarig sjukdom, Uppsala universitet, Åsenlöf: Fysioterapi
Öhlén, Joakim, Professor (opponent)
The Sahlgrenska Academy, University of Gothenburg
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ISBN 978-91-513-0950-7
Uppsala : Acta Universitatis Upsaliensis, 2020
Engelska 101s.
Serie: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206
  • Doktorsavhandling (övrigt vetenskapligt)
Abstract Ämnesord
Stäng  
  • <p><strong>Background and Aim </strong>Being diagnosed with cancer is often described as a major loss of control leading to severe psychological distress and symptoms of anxiety and depression can continue to affect the individual in the long term. The cancer and its treatment may influence all dimensions of health, thus the psychosocial support provided needs to be multifaceted and easy accessed. Internet-based interventions may be one way to provide such support, but evidence is limited. This thesis aimed to investigate the design, effects, and experiences of internet-based psychosocial support in cancer.</p><p><strong>Methods and Results </strong>Study 1 encompassed a co-creation development process resulting in the interactive support provided as the first step in an internet-based stepped care intervention (iCAN-DO). The effects of iCAN-DO were investigated in a randomised controlled trial, targeting individuals newly diagnosed with cancer and concurrent self-reported symptoms of anxiety and depression (according to the Hospital Anxiety and Depression Scale). Step 1 had a psycho-educative content involving self-care strategies and was available to the intervention group during the ten-month study period. Step 2 comprised a guided internet-based cognitive behavior therapy (iCBT) program and was offered those without improvement in anxiety and depression after using Step 1. The results showed that iCAN-DO improved symptoms of depression compared with standard care, while symptoms of anxiety were largely unaffected. Most participants used Step 1, while only a few used Step 2.</p><p>In Study 2, aspects of usefulness, relevance, and usability in iCAN-DO were explored through qualitative interviews, analysed using content analysis. Results showed that standard healthcare did not meet the individuals' needs and iCAN-DO was used as complement, providing access to relevant, trustworthy information and support. Usability was affected by the perceived usefulness and ease of use of the intervention, as well as by the user´s circumstances in life and consequences of the cancer. The co-creation process in the development of Step 1 added relevance, but both steps 1 and 2 would have gained from being provided earlier, integrated into standard healthcare and more adaptable to the individual.</p><p><strong>Conclusion </strong>The thesis concluded that the internet-based intervention had positive effects on symptoms of depression in individuals newly diagnosed with cancer. Individuals with cancer experience several unmet needs in standard healthcare and since psycho-educative support including self-care advice seems feasible in this group, efforts are needed to incorporate internet-based support in regular oncology care. Since the intervention did not target all symptoms (i.e. anxiety) further research is needed on how to enhance efficacy and how to make iCBT more feasible for this group.</p>

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  (hsv//swe)
MEDICAL AND HEALTH SCIENCES  (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskaper -- Omvårdnad (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

Nyckelord

Internet
eHealth
Nursing
Oncology
Cancer
Anxiety
Depression
Psychosocial Intervention
Technology-Based Interventions
Stepped Care
Caring Sciences
Vårdvetenskap

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