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Birgit Watzke, Dr. phil., Dipl.-Psych.
Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf
Martinistraße 52 (Haus W26)
20246 Hamburg
Tel.: +49-(0)40-74105-4883 / Fax: - 4940
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Internet-based outpatient psychosocial aftercare following inpatient oncology rehabilitation: Process and outcome quality of an E-Mental-Health Module.

Background/Aims

Against the background of the optimisation potential of the German health care system in terms of a cross-sector “integrated” care, the goal of the project is to scientifically examine the benefit of the internet for the area of psychosocial aftercare following inpatient oncology rehabilitation. With the nowadays high – and still growing – pervasiveness of modern communication technologies, new possibilities to shape a rehabilitation aftercare through these technologies are currently emerging. With the development and implementation of new web-based care models, their effectiveness as well as conducive and inhibitory factors of utilisation need to be examined – also with respect to a greater patient orientation.

In the framework of the project, an outpatient, location-independent and prompt Internet offer in the form of chat groups (eAftercare under guidance of a psychotherapist with twelve sessions over three months) for patients with breast cancer and patients with prostate cancer and gastroenterological-oncology diseases will be developed and examined in terms of its effectiveness. The eModule (the chat group) is an open, (psycho-) therapeutically driven group offer according to the approach of an “open-ended” group with a strongly interaction-based alignment. The pre-structured framework is strongly oriented to the needs, problems and resources of the patients.

 

Methods

With the chosen study approach, the aim is to realise a randomised design (to strengthen internal validity) in the examination of a clinically representative patient sample (to strengthen external validity and the possibility to generalise findings to everyday clinical practice): With reference to the approach of care research, a prospective multiple time point survey (before and after inpatient rehabilitation, after the eAftercare and at the 6-month follow-up) should be realised.

Patients receiving eAftercare will be compared with patients receiving “treatment as usual” (i.e. no specific eAftercare) with respect to their treatment success (quality of life, functional health, emotional well-being etc.). Process analyses (process parameters, in particular activity of the patient and feeling of belonging, relate to a positive evaluation of the groups) supplement the design.

If evaluation results are correspondingly positive, an efficient eAftercare module for routine care will be made available. Moreover, with the study, an empirical basis can be laid for potential transfers to acute treatment (e.g. during outpatient chemotherapy treatment), or also, above all, to other indication areas, e.g. other chronic diseases.

 

Current status

In the first project phase, the Internet-based group program that constitutes the basis for the eAftercare, i.e. the intervention to be examined, was manualised. A pilot phase in one clinic (Paracelsus-Klinik Am See, Bad Gandersheim) has been successfully completed, although the recruitment rates lie clearly below the calculated sample sizes. Currently, the study is being routinely implemented in a clinic and in parallel in two further establishments.




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