Can a tailored telephone intervention delivered by volunteers reduce the supportive care needs, anxiety and depression of people with colorectal cancer? A randomised controlled trial.

OBJECTIVE: The objective was to assess the effectiveness of a volunteer-delivered tailored telephone-based intervention in reducing prevalence of unmet supportive care needs, elevated levels of anxiety and depression among people with colorectal cancer over a 9-month period. METHODS: There were 653 participants who completed the baseline questionnaire and were randomised to usual care (n = 341) or intervention (n = 306). Three follow-up questionnaires were completed at 3-monthly intervals (response rates: 93%, 87%, 82%, respectively). All four questionnaires contained the Supportive Care Needs Survey (SCNS), Hospital Anxiety and Depression Scale (HADS) and checklists for colorectal cancer symptoms and use of support services. The intervention consisted of trained volunteers providing emotional support, service referral and information and was delivered after completion of each of the first three questionnaires. Primary outcomes were prevalence of moderate to high SCNS needs and elevated levels (scores of 8+) of HADS anxiety and depression. RESULTS: Over the study period, SCNS needs decreased similarly for both groups, and prevalence of elevated depression did not change for either group. There was a greater reduction in the prevalence of elevated anxiety in the intervention than usual care group (p < 0.01), with the intervention group decrease mainly occurring between baseline and the first follow-up survey (p < 0.01). However, the prevalence of elevated anxiety was similar between the two groups at each follow-up point. CONCLUSIONS: The intervention had no effect on supportive care needs or depression, although it may be associated with a greater reduction in anxiety. Future research should test the intervention with patients closer to diagnosis.

One-to-one volunteer support programs for people with cancer: a review of the literature.

OBJECTIVE: To conduct a systematic review of literature reporting on the use of volunteers in support programs for people with cancer. METHODS: PsycINFO, Medline and CINAHL were used to identify papers published up to April 2007 reporting one-to-one support programs using volunteers. Program data were extracted from the papers, which were rated on research quality and descriptions of the program, volunteers and support recipients. RESULTS: Twenty-eight papers were reviewed. Nineteen (69%) reported peer-support programs, with four (14%) pertaining to the Reach to Recovery program for women with breast cancer, and eight (28%) describing other peer-support programs for women with breast cancer. Few papers described the programs sufficiently to enable a good understanding of support recipients, volunteers, and what transpired between volunteers and support recipients. Twenty papers (71%) were research studies: 10 (36%) with one group descriptive data, 6 (21%) were non-randomized comparative studies and 4 (14%) were randomized controlled trials. CONCLUSION: While most papers reported that programs were beneficial, few presented data from studies using rigorous research methodologies to support these claims. PRACTICE IMPLICATIONS: Using volunteers in cancer care may have merits; however, papers need to provide more information regarding these programs and further evidence is required to determine their effectiveness.

Reducing the unmet needs of patients with colorectal cancer: a feasibility study of The Pathfinder Volunteer Program.

GOALS OF THE WORK: Many cancer patients experience unmet needs and elevated levels of anxiety and depression. This paper describes a volunteer-delivered intervention to reduce the psychosocial needs of cancer patients and presents findings from a feasibility study of this intervention. MATERIALS AND METHODS: The telephone-based intervention, called the Pathfinder Program, involves the assignment of volunteers to patients to assist them in addressing their needs as identified in questionnaires. Fifty-two patients with colorectal cancer were involved in the feasibility study, with 18 in the intervention. Sixty-two percent of the sample was male and the mean age was 64 years. Patients' needs were assessed using The Supportive Care Needs Survey, a colorectal cancer symptom checklist, and the Hospital Anxiety and Depression Scale. All patients completed baseline questionnaires (Time 1) and 47 completed Time 2 questionnaires 3 months later. MAIN RESULTS: The most common needs were fear of the cancer spreading and returning, concerns about the worries of others, gas or wind, changes in weight, and bowel problems such as diarrhea, constipation, and pain. A statistically significant Time 1 to Time 2 decrease in supportive care needs and depression was found for the intervention group. CONCLUSIONS: The Pathfinder Program has been found to be feasible, acceptable for patients, and has the potential to reduce needs and depression. A larger, randomized controlled trial is needed to determine the impact of this program on colorectal symptoms and anxiety.