Problem-solving skills training in adult cancer survivors: Bright IDEAS-AC pilot study

Abstract

Purpose: Cancer patients experience significant distress and burden of decision-making throughout treatment and beyond. These stressors can interfere with their ability to make reasoned and timely decisions about their care and lead to low physical and social functioning and poor survival. This pilot study examined the impact of offering Problem-Solving Skills Training (PSST) to adult cancer survivors to help them and their caregivers cope more successfully with post-treatment decision-making burden and distress.

Patients and methods: Fifty patients who completed their definitive treatment for colorectal, breast or prostate cancer within the last 6 months and reported distress (level > 2 on the National Comprehensive Cancer Network distress thermometer) were randomly assigned to either care as usual (CAU) or 8 weekly PSST sessions. Patients were invited to include a supportive other (n = 17). Patient and caregiver assessments at baseline (T1), end of intervention or 3 months (T2), and at 6 months (T3) focused on problem-solving skills, anxiety/depression, quality of life and healthcare utilization. We compared outcomes by study arm and interviewed participants about PSST burden and skill maintenance.

Results: Trial participation rate was 60%; 76% of the participants successfully completed PSST training. PSST patients reported reduction in anxiety/depression, improvement in QoL (p < 0.05) and lower use of hospital and emergency department services compared to CAU patients (p = 0.04).

Conclusions: The evidence from this pilot study indicates that a remotely delivered PSST is a feasible and potentially effective strategy to improve mood and self-management in cancer survivors in community oncology settings.

Trial registration: ClinicalTrials.gov NCT03567850.

Figure 1.. Outcome measures at T1 (pre-randomization), T2 (immediately postintervention) and T3 (6 months post-randomization).

Mean + SE. Individual components of SPSI-R:S: Rational Problem Solving (RPS), Impulsivity/Carelessness Style (ICS); Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Cancer Therapy- General (FACT-G). Bars represent 95% confidence intervals.