Abstract
BackgroundInformation on the prevalence of adjustment disorders among cancer patients and the value of psychological interventions in this group of patients is limited. This study investigates the prevalence of adjustment disorders among cancer patients as well as the reach, effectiveness, cost-utility and budget impact of a tailored psychological intervention.MethodThis study consists of two parts. Part 1 is an observational study among a representative group of mixed cancer patients after cancer treatment on the prevalence of adjustment disorder as well as the uptake (i.e. reach) of psychological treatment. In Part 2, patients diagnosed with an adjustment disorder are invited to participate in a randomized controlled trial. Patients will be randomized to the intervention (access to the tailored psychological intervention) or control group (waitlist period of 6 months). The psychological intervention consists of three modules: one module containing psycho-education (3 sessions, all patients) and two additional modules (maximum of 6 sessions per module) provided as continuum, in case needed. Module 2 and 3 can consist of several evidence-based interventions (e.g. group interventions, mindfulness, eHealth) The primary outcome is psychological distress (HADS). Secondary outcomes are mental adjustment to cancer (MAC) and health-related quality of life (EORTC QLQ-C30). To assess the cost-utility and budget impact, quality of life (EQ-5D-5 L) and costs (iMCQ and iPCQ) will be measured. Measures will be completed at baseline and 3 and 6-months after randomization.DiscussionThis study will provide data of the prevalence of adjustment disorders and the reach, effectiveness, cost-utility and budget impact of a tailored psychological intervention.Trial registrationNetherlands Trial Register identifier: NL7763. Registered on 3 June 2019.
Highlights
Information on the prevalence of adjustment disorders among cancer patients and the value of psychological interventions in this group of patients is limited
There is convincing empirical evidence that cancer patients have to deal with a wide range of physical symptoms and psychological, social and existential problems related to cancer and its treatment, both during treatment and at followup
Earlier studies showed prevalence rates of adjustment disorder varying from 6% to over 19%, as measured using diagnostic interviews
Summary
Information on the prevalence of adjustment disorders among cancer patients and the value of psychological interventions in this group of patients is limited. This study investigates the prevalence of adjustment disorders among cancer patients as well as the reach, effectiveness, cost-utility and budget impact of a tailored psychological intervention. Psychological problems involve symptoms related to anxiety and depression, and problems with adjustment to cancer and its sequelae [2]. In case of severe and persistent problems with adjustment to cancer, an adjustment disorder can be diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) [3]. An adjustment disorder is characterized by symptoms such as anxiety, depression or fatigue and can be developed in case of insufficient protective factors (e.g. resilience or meaning making), which can result in significant impairments in a patients’ life (e.g. work or study, social relations or emotional problems) [3]
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