A nurse- and peer-led psycho-educational intervention to support women with gynaecological cancers receiving curative radiotherapy: The PeNTAGOn randomised controlled trial - ANZGOG 1102

P Schofield; K Gough; M Pascoe; R Bergin; K White; L Mileshkin; D Bernshaw; N Kinnane; M Jackson; V Do; A Brand; S Aranda; R Cheuk; A Drosdowsky; S Penberthy; I Juraskova

doi:10.1016/j.ygyno.2020.09.016

A nurse- and peer-led psycho-educational intervention to support women with gynaecological cancers receiving curative radiotherapy: The PeNTAGOn randomised controlled trial - ANZGOG 1102

Gynecol Oncol. 2020 Dec;159(3):785-793. doi: 10.1016/j.ygyno.2020.09.016. Epub 2020 Sep 19.

Authors

P Schofield¹, K Gough², M Pascoe³, R Bergin⁴, K White⁵, L Mileshkin⁶, D Bernshaw⁷, N Kinnane⁸, M Jackson⁹, V Do¹⁰, A Brand¹¹, S Aranda¹², R Cheuk¹³, A Drosdowsky¹⁴, S Penberthy¹⁵, I Juraskova¹⁶

Affiliations

¹ Behavioural Sciences Unit, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, VIC 3000, Australia; Department of Psychological Science, Iverson Health Innovation Research Institute Swinburne University of Technology, John St, Hawthorn, VIC 3122, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC 3010, Australia. Electronic address: Pschofield@swin.edu.au.
² Cancer Care Delivery Research, Department of Cancer Experiences, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, VIC 3000, Australia. Electronic address: Karla.gough@petermac.org.
³ Behavioural Sciences Unit, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, VIC 3000, Australia; Institute for Health and Sport, Victoria University, Ballarat Road, Footscray, VIC 3011, Australia. Electronic address: Michaela.Pascoe@vu.edu.au.
⁴ Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004, Australia. Electronic address: Rebecca.Bergin@cancervic.org.au.
⁵ Cancer Nursing Research Unit, Level 6-North, Chris O'Brien Lifehouse, The University of Sydney, NSW 2006, Australia. Electronic address: Kate.white@sydney.edu.au.
⁶ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC 3010, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, VIC 3000, Australia. Electronic address: Linda.mileshkin@petermac.org.
⁷ Department of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, VIC 3000, Australia. Electronic address: David.Bernshaw@petermac.org.
⁸ Department of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, VIC 3000, Australia. Electronic address: Nicole.kinnane@petermac.org.
⁹ Prince of Wales Clinical School, UNSW Sydney, NSW 2052, Australia. Electronic address: Michael.Jackson2@health.nsw.gov.au.
¹⁰ Department of Radiation Oncology, Liverpool Cancer Therapy Centre, 1 Campbell St, Liverpool, NSW 2170, Australia; South Western Sydney Clinical School, University of New South Wales Medicine, 18 High St, Kensington, NSW 2052, Australia. Electronic address: Viet.do@health.nsw.gov.au.
¹¹ Department of Gynaecological Oncology, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia. Electronic address: Alison.brand@health.nsw.gov.au.
¹² Cancer Council Australia, 14/477 Pitt St, Sydney, NSW 2000, Australia. Electronic address: Sanchia.aranda@cancer.org.au.
¹³ Cancer Care Services, Joyce Tweddell Building, Royal Brisbane and Women's Hospital, Butterfield St, Herston, QLD 4029, Australia. Electronic address: Robyn.Cheuk@health.qld.gov.au.
¹⁴ Cancer Care Delivery Research, Department of Cancer Experiences, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, VIC 3000, Australia. Electronic address: Allison.Drosdowsky@petermac.org.
¹⁵ Behavioural Sciences Unit, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, VIC 3000, Australia.
¹⁶ Centre of Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Brennan MacCallum Building A18, Manning Road, Camperdown, NSW 2050, Australia. Electronic address: ilona.juraskova@sydney.edu.au.

PMID: 32962898
DOI: 10.1016/j.ygyno.2020.09.016

Abstract

Objective: Radiotherapy for gynaecological cancer is associated with multiple adverse effects. This randomised controlled trial evaluated the impact of a combined nurse- and peer-led psycho-educational intervention on psychological distress, preparation for treatment, quality of life, psychosexual function, unmet needs and vaginal stenosis.

Methods: Eligible women had a confirmed diagnosis of gynaecological cancer, scheduled to receive radiotherapy with curative intent, aged ≥18 years, and able to read and write English. Participants randomly assigned one-to-one to either four nurse-led consultations plus four peer-led telephone sessions, or to usual care. Participants completed study measures at baseline, immediately before first radiotherapy (FU1), and four weeks (FU2), three (FU3), six (FU4), and 12 months (FU5) post radiotherapy. The primary outcomes were psychological distress at FU1 and FU2 measured by the Hospital Anxiety and Depression Scale.

Results: Of 840 eligible participants, 625 were approached and 319 (51%) consented; 158 assigned to intervention, 160 to usual care with 1 withdrawing before randomisation. Between-groups differences for primary outcomes were trivial- and small-sized, (both p > 0.05). Notable effects on secondary outcomes favouring the intervention at FU2 included preparation for treatment (sensory/psychological concerns, d = 0.57; and procedural concerns, d = 0.52) and specific needs domains (sexuality needs, d = 0.38; and health system and information needs, d = 0.41).

Conclusions: There was no evidence that a nurse- and peer-led intervention had a beneficial effect on psychological distress compared to usual care. However, improved treatment readiness and lower health system and sexuality needs indicate the intervention may have addressed outcomes known to be important to this population.

Keywords: Gynaecological cancer; Nurse-led intervention; Peer support; Psychological distress; Radiotherapy; Randomised controlled trial; Supportive care needs.

Publication types

Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Anxiety
Cancer Survivors / psychology
Depression
Female
Follow-Up Studies
Genital Neoplasms, Female / radiotherapy*
Humans
Middle Aged
Nurses / organization & administration
Patient Education as Topic / methods*
Patient Education as Topic / organization & administration
Prospective Studies
Psychological Distress*
Quality of Life
Radiotherapy / adverse effects
Radiotherapy / psychology
Referral and Consultation / organization & administration*
Self-Help Groups / organization & administration
Sexuality / psychology*
Telephone
Treatment Outcome

Associated data

ANZCTR/ACTRN12611000744954