title: Psychoeducational Intervention to Reduce Fear of Cancer Recurrence in People at High Risk of Developing Another Primary Melanoma: Results of a Randomized Controlled Trial.
abstract: Purpose People with a history of melanoma commonly report a fear of cancer recurrence (FCR), yet psychologic support is not routinely offered as part of ongoing melanoma care. This randomized controlled trial examined the efficacy of a psychoeducational intervention to reduce FCR and improve psychologic adjustment in this patient group compared with usual care. Methods The intervention comprised a newly developed psychoeducational resource and three telephone-based psychotherapeutic sessions over a 1-month period timed in accordance with dermatologic appointments. Participants were randomly assigned to intervention (n = 80) or usual care (n = 84). Assessments were completed at baseline, 1 month, and 6 months after dermatologic appointments. Linear mixed models were used to examine differences between treatment and control groups for patient-reported outcomes, including FCR, anxiety, stress, depression, melanoma-related knowledge, health behaviors, satisfaction with melanoma care, unmet needs, and health-related quality of life. Results At 6 months, the intervention group reported lower FCR severity, trigger, and distress scores than the control group in the baseline-adjusted models; the between-group mean difference was -1.9 for FCR severity (95% CI, -3.1 to -0.7; P = .002), -2.0 for FCR triggers (95% CI, -3.3 to -0.7; P = .003), and -0.7 for FCR distress (95% CI, -1.3 to -0.1; P = .03). The decrease in FCR severity (but not triggers or distress) remained statistically significant after adjustment for other covariates ( P = .04). At 6 months, the intervention group also reported lower stress (-1.6; 95% CI, -3.1 to -0.2; P = .03) and improved melanoma-related knowledge (1.7; 95% CI, 0.8 to 2.6; P < .001) compared with the control group. No differences were found between groups for other secondary outcomes. Conclusion This newly developed evidence-based psychoeducational intervention was effective in reducing FCR and stress and increasing melanoma-related knowledge in people at high risk for another melanoma.
authors.affiliation: Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of Sydney; Shab Mireskandari, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney; Graham J. Mann, Westmead Institute for Medical Research, The University of Sydney; Scott W. Menzies, Royal Prince Alfred Hospital; Nadine A. Kasparian, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Mbathio
authors.initials: M
authors.lastname: Dieng
authors.affiliation: Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of Sydney; Shab Mireskandari, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney; Graham J. Mann, Westmead Institute for Medical Research, The University of Sydney; Scott W. Menzies, Royal Prince Alfred Hospital; Nadine A. Kasparian, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
authors.affiliation: Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of Sydney; Shab Mireskandari, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney; Graham J. Mann, Westmead Institute for Medical Research, The University of Sydney; Scott W. Menzies, Royal Prince Alfred Hospital; Nadine A. Kasparian, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Daniel S J
authors.initials: DS
authors.lastname: Costa
authors.affiliation: Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of Sydney; Shab Mireskandari, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney; Graham J. Mann, Westmead Institute for Medical Research, The University of Sydney; Scott W. Menzies, Royal Prince Alfred Hospital; Nadine A. Kasparian, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Rachael L
authors.initials: RL
authors.lastname: Morton
authors.affiliation: Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of Sydney; Shab Mireskandari, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney; Graham J. Mann, Westmead Institute for Medical Research, The University of Sydney; Scott W. Menzies, Royal Prince Alfred Hospital; Nadine A. Kasparian, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Menzies
authors.affiliation: Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of Sydney; Shab Mireskandari, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney; Graham J. Mann, Westmead Institute for Medical Research, The University of Sydney; Scott W. Menzies, Royal Prince Alfred Hospital; Nadine A. Kasparian, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Shab
authors.initials: S
authors.lastname: Mireskandari
authors.affiliation: Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of Sydney; Shab Mireskandari, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney; Graham J. Mann, Westmead Institute for Medical Research, The University of Sydney; Scott W. Menzies, Royal Prince Alfred Hospital; Nadine A. Kasparian, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Tesson
authors.affiliation: Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of Sydney; Shab Mireskandari, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney; Graham J. Mann, Westmead Institute for Medical Research, The University of Sydney; Scott W. Menzies, Royal Prince Alfred Hospital; Nadine A. Kasparian, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Mann
authors.affiliation: Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of Sydney; Shab Mireskandari, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney; Graham J. Mann, Westmead Institute for Medical Research, The University of Sydney; Scott W. Menzies, Royal Prince Alfred Hospital; Nadine A. Kasparian, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Cust
authors.affiliation: Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of Sydney; Shab Mireskandari, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney; Graham J. Mann, Westmead Institute for Medical Research, The University of Sydney; Scott W. Menzies, Royal Prince Alfred Hospital; Nadine A. Kasparian, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Nadine A
authors.initials: NA
authors.lastname: Kasparian
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000523:psychology*; D009517:New South Wales; D010353:Patient Education as Topic / Q000379:methods*; D011379:Prognosis; D011613:Psychotherapy / Q000379:methods*; D018434:Sickness Impact Profile; D012878:Skin Neoplasms / Q000401:mortality / Q000523:psychology / Q000628:therapy; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome