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Projekt Krop & SindInternet-delivered Mindfulness-Based Cognitive Therapyfor women treated for breast cancer and men treated for
prostate cancer
Eva Rames Nissen, MSc Psychology, PhD-Student [email protected]
Unit for Psychooncology and Health Psychology, AU, AUH
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The present project
Internet-delivered Mindfulness-Based Cognitive Therapy for symptoms of depression, anxiety and stress among women treatedfor breast cancer and men treated for prostate cancer
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• Psychological distress among cancer survivors
• Effective treatment: Mindfulness-BasedCognitive Therapy (MBCT)
• Use of MBCT is limited because:• Lack of educated intructors
• Practical implications for patients
→ Internet-delivered MBCT (I-MBCT)
ClinicalTrials.org NCT03100981, Piet, Würtzen & Zachariae (2012), Johannsen et al. (2016)
The present project
• Project and intervention planning– in collaboration with patient representatives
• Intervention platform– Collaboration with the Internet Psychiatry at Karolinska Institutet and Psykiatri
Sydväst, Stockholm, Sweden
• Intervention content– Development of a text-based intervention based on the manual for
Mindfulness-Based Cognitive Therapy
• Study– Randomized Controlled Trial of the efficacy of the intervention
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Project and intervention planning
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Meeting 1:- Introduction to project- Preparation of interviews
Meeting 2:- Evaluation of interviews- Discussing program material
Meeting 3:- Test of program draft- Information material
- Video recordings with members of the sharedworking group
Interviews
DevelopingI-MBCT
RCT
FeasibilityStudy
Meeting 4:- Feedback on program- Results from feasibility study- Evaluation of working group
FinalizingI-MBCT
Involvement of a shared working group with patient representatives and researchers
3 women treated for breast cancer2 men treated for prostate cancer4 researchers1 research assistant
Patient Involvement in Research
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What we can affect
”Circle of control”
What we cannotaffect
MBCT manual
Project economy
Timeframe of project
Platform
Information material
Formulations in program
Video material
How and when weapproach patients
Patient Involvement in Research
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”What does ‘cognitive’ mean?(in Mindfulness-Based Cognitive Therapy)
”Why do you ‘request people to participate’ instead of offering them
a really valuable intervention?”
”Why do you present the hardwork first and the potential
benefits last?”
”It feels like the hormones are
rushing in my bodyand that the
deamons are rushingin my head”
Framing and facilitation
What we did• Facilitation of
collaboration• Atmosphere• Meal• Introduction round• Name tags• Sense of equality• Practical help
Nissen et al. (2018)
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Key changes
I-MBCT program• Text• Cases• Visual structure• Video examples
RCT• Interview guide• Recruitment procedure• Information material• Outcome measures
Overall• How we think about and do research• Contribution to others• New perspectives
Nissen et al. (2018)
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Project and intervention planning
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Platform
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• Erfaringer• Ressourcer
• Oversættelse• Tværfaglighed
Platform
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• Begrænsninger• Data
Intervention Content
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• Manualbaseret• Terapi på skrift
Intervention Content
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• Formuleringer og hensigter
• Opsætning og struktur
Intervention Content
• Omfang af tekstmateriale
Efficacy study – preliminary results
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n=1284 (BC: 987 PC:297)
n=150(BC: 137 PC:13)
n=104 ; n=46(BC: 96 ; 41 PC: 8 ; 5)
n=74 ; n=37(BC: 66 ; 32 PC: 8 ; 5)
Prospective considerations
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• Why does it seem to work better for men/prostate cancer patients?
• Will a more user-friendly platform improve feasibility and reduce drop-out-rate?
• How can we implement the intervention more broadly?
• Is I-MBCT the ”best” intervention for this patient population?
AcknowledgementsFunding:• The Danish Cancer Society• TrygFonden• Central Region Denmark
Collaborators:• Unit for Psychooncology and Health
Psychology– Prof. Bobby Zachariae– Dr. Mimi Mehlsen– Dr. Maja O’Connor– Ms. Anne Kathrine Østerby Muldbjerg
• Department of Oncology, Aarhus University Hospital
– Dr. Inger Højriis
• Department of Urology, Aarhus University Hospital– Prof. Michael Borre
• Karolinska Institutet and Psykiatri Sydväst, Stockholms Läns Landsting, Sweden
– Prof. Viktor Kaldo– Prof. Nils Lindefors
• Research Programme for Patient Involvement, Aarhus University and Aarhus University Hospital
– Prof. Kirsten Lomborg– Dr. Vibeke Bregnballe
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