T-5224 br c Psychosocial Oncology Program McGill Universit
c Psychosocial Oncology Program, McGill University Health Centre, Montreal, Canada
d Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
e Counselling Services, McGill University, Montreal, Canada
f Department of Mathematics and Statistics, McGill University, Montreal, Canada
g Department of Psychology, The King's University, Edmonton, Canada
h Departments of Psychology, Oncology and Psychiatry, McGill University, Montreal, Canada
Randomized controlled trial
Quality of life
Objective: Bibliotherapy refers to psychological self-help interventions that utilize treatment books to improve psychological well-being. Research supports bibliotherapy as an efficacious intervention for a variety of mental health problems. Yet, few studies have investigated bibliotherapy in psychosocial oncology. The objective of this T-5224 randomized controlled trial was to examine the efficacy of the NuCare intervention, delivered as a self-directed workbook, for enhancing empowerment, coping, and quality of life and reducing distress in patients with cancer.
Methods: Eighty-nine adult patients with cancer were randomized to receive the workbook for 6 weeks or the control condition, usual care. Participants completed questionnaires at baseline, 6 weeks post-baseline, and 10 weeks post-baseline.
Results: The increase of empowerment (main outcome) and quality of life and the decrease of distress in the NuCare group from pre-intervention to follow-up assessment differed significantly from the respective difference scores in the control group.
Conclusions: The self-administered NuCare workbook is a potentially cost-effective, minimal intervention addressing psychosocial needs of patients with cancer.
Practice implications: Evidence-based bibliotherapy can empower patients and has the promise of reducing the burden on the healthcare system while enhancing the immediacy of psychosocial support. © 2018 Elsevier B.V. All rights reserved.
Bibliotherapy has been defined in a number of ways but essentially means helping people through the use of books . In current clinical contexts, bibliotherapy generally refers to psychological self-help interventions crustaceans utilize treatment books . Advances in technology have made books readily available on the internet, as such, the term bibliotherapy is increasingly being used to include the use of books as well as
* Corresponding author at: McGill University, Counselling Psychology Program, 3700 McTavish Street, suite 614, Montreal, Quebec, H3A 1Y2, Canada. E-mail address: [email protected] (A. Körner).
internet-based reading materials [3–5]. While lacking the therapeutic relationship with a mental health care professional, there are certain benefits associated with workbooks designed to help people overcome psychosocial difficulties [6,7]. Self-administered interventions have the potential to reach patients in need when routine care is not equipped to overcome accessibility or delivery constraints, such as the lack of mental health specialists in physical healthcare care settings, geograph-ical barriers in remote areas, disease-related factors (e.g., impaired mobility, fatigue), patient preferences for being referred to a nurse rather than a psychologist or reluctance to receive any professional help for alleviating distress [8–12]. Self-directed interventions may be experienced as less stigmatizing than face-to-face individual or group treatments, allowing
patients to privately access support resources while working at their own pace [8,13]. Research also suggests that engaging in self-management is empowering and enhances a sense of control, self-efficacy, self-reliance, and autonomy [11,14–18].