Abstract
Breast cancer is the most common cancer in women worldwide, with increases in diagnoses at all ages. Due to several age-related factors, older breast cancer patients show particular difficulties in adjusting to breast cancer and its related treatments. One consistent indicator of vulnerability to long-term complications is emotional distress occurring within 3 months of diagnosis. Thus, it is critical to develop early interventions specifically aimed at mitigating distress and promoting emotional wellbeing in older breast cancer patients. By taking advantage of the opportunities of online interventions, the present study aimed to test the efficacy of a 2 weeks e-health stress inoculation training (SIT) intervention on emotion regulation and cancer-related well-being, compared with a control group without such intervention. Twenty-nine women with a diagnosis of breast cancer, who had received radical surgery and who were suitable candidates for adjuvant chemotherapy with anthracyclines and taxanes (mean age = 62.76; SD = 6.19) voluntarily took part in the current study after giving written informed consent. To test intervention efficacy, self-report questionnaires were administered to all participants at baseline, at the end of the 2 weeks intervention, and 3 months after the end of the intervention. Results showed that after 2 weeks of ehealth intervention, patients did not achieve significant change, however, they significantly reduced emotional suppression and increased cancer-related emotional well-being 3 months after the end of the intervention. Furthermore, by monitoring at a distance the emotional experience during the online intervention, we found an increase in relaxation and a reduction of anxiety. Finally, patients in the experimental group reported a good level of acceptance of the ehealth intervention. To conclude, designing and developing eHealth interventions as part of the regular care path for breast cancer patients of all ages represents both a challenge and an opportunity; in particular, online interventions can be an important step in universal psychosocial care within a tiered model of care.
Highlights
Breast cancer is the most common cancer in women worldwide
We compared the E-Health Group (EHG) and the Control Group (CG) at the baseline in order to detect any difference in the considered variables at the beginning of the study
Independent sample t-tests indicated that the two groups did not differ either in their emotion regulation strategies (ERQ - cognitive eHealth Intervention for Breast Cancer Patients reappraisal: t(27) = 0.928, p = 0.361; emotional suppression: t(27) = −1.156, p = 0.258), or in their wellbeing related to the cancer [FACT-B – Physical wellbeing (PWB): t(27) = 1.587, p = 0.124; Social wellbeing (SWB): t(27) = 1.669, p = 0.107; Emotional wellbeing (EWB): t(27) = 0.695, p = 0.493; Functional wellbeing (FWB): TABLE 1 | Descriptive data for EQR and FACT-B questionnaires
Summary
Breast cancer is the most common cancer in women worldwide. With increases in diagnoses at all ages – even if more slowly between 50 and 80 years of age (DeSantis et al, 2011) – more women will have to deal with breast cancer and its consequences (van Ee et al, 2017b).From a psychological point of view, the literature is not consistent about women’ experiences related to age. Women of different ages have many experiences in common regarding breast cancer that imply a deterioration of well-being and quality of life (Montazeri, 2008; CampbellEnns and Woodgate, 2016), older women do not have to deal with the non-normative nature of a chronic disease at a relatively young age, which typically causes disruption in multiple life roles (Dunn and Steginga, 2000; Thewes et al, 2004). They are less challenged by job demands, taking care of a young family, and fertility issues (Rana et al, 2017). A variety of age-related aspects can make it more stressful for older patients to deal with the diagnosis and treatment of breast cancer (Park et al, 2011)
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