title: Internet-based program for coping with cancer: a randomized controlled trial with hematologic cancer patients.
abstract: OBJECTIVE
  Psychosocial patient care in oncology is no longer limited to the inpatient setting. Outpatient services are in demand. Internet-based interventions could aid in optimizing service delivery across disciplines. The effectiveness of an Internet-based program for hematologic cancer patients was tested in a randomized controlled trial under field experimental conditions.
  
  
  METHODS
  A 4-week cognitive-behavioral program for coping with cancer was offered to hematologic cancer patients online. One hundred eighty-six registrants were randomly assigned to an intervention group (n = 105) or a waiting list (n = 81). The outcome measures, 'mental adjustment' (MAC) and 'psychological distress' (BSI), were assessed at registration and after 4 weeks. Patient satisfaction was assessed (ZUF-8), and complete-cases and intention-to-treat analyses were performed.
  
  
  RESULTS
  At registration, the majority of participants displayed clinically significant distress (BSI) and lacked alternative access concerning psychosocial care. One hundred eleven patients filled out the post questionnaire at 4 weeks. In contrast to the waiting list, the intervention group displayed a significant increase in fighting spirit (d = 0.42; CI 95%, 0.04 to 0.80). The effect was confirmed by intention-to-treat analysis (d = 0.33; CI 95%, 0.04 to 0.62). Otherwise, no effects were observed. Patient satisfaction with the program was high.
  
  
  CONCLUSIONS
  The results demonstrate the potential efficacy of Internet-based programs while highlighting their limitations. Future research is needed to clarify and optimize efficacy, taking different program components and patient characteristics into particular consideration.
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-University Tübingen, Germany. niklas.david@uni-tuebingen.de
authors.forename: N
authors.initials: N
authors.lastname: David
authors.forename: P
authors.initials: P
authors.lastname: Schlenker
authors.forename: U
authors.initials: U
authors.lastname: Prudlo
authors.forename: W
authors.initials: W
authors.lastname: Larbig
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D019337:Hematologic Neoplasms / Q000523:psychology*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011581:Psychological Tests; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires; D055815:Young Adult