Comparison of Online with Offline Cognitive-Behavioral Stress Caring Program in Prostate Cancer Survivors after Prostatectomy: A Prospective, Propensity Score-Matched, Cohort Study.

Abstract

Offline cognitive-behavioral stress caring program (CBSC) modifies maladaptive cognition and improves management stress skills, which relieves mental disorders in some cancer patients; however, it is limited by space and time. This study compared the effect of online and offline CBSC on mental health, spiritual well-being, fatigue, and patient satisfaction in prostate cancer survivors after prostatectomy. Totally, 147 prostate cancer survivors after prostatectomy were divided into offline (n = 89) and online (n = 58) CBSC groups. CBSC included stress management, relaxation, disease-relevant education, and weekly homework. Selection bias was adjusted by matching patients in both groups (1:1) using propensity scores (n = 58 in both groups after adjustment). Hospital Anxiety and Depression Scale (HADS)-anxiety, HADS-depression, Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale (FACIT-SP), the brief fatigue inventory-China (BFI-C), and patient satisfaction score (PSS) were evaluated. 'Improvement' was defined as positive improvement values in indexes after a 10-week CBSC. Before and after adjustment, HADS-anxiety, HADS-depression, FACIT-SP, BFI-severity, and BFI-interference scores were improved at week 10 vs. baseline in the online or offline CBSC group. However, these scores did not vary at baseline or week 10 between groups. The improvement of HADS-anxiety, HADS-depression, and FACIT-SP scores was smaller in online CBSC group than in offline CBSC group. The improvement of BFI-severity and BFI-interference scores were non-differential between groups. PSS scores were reduced in online CBSC group vs. offline CBSC group. Overall, online CBSC alleviates mental disorders, elevates satisfaction, and relieves fatigue in prostate cancer survivors after prostatectomy, but its overall effect is less than offline CBSC.