Investigating Adherence to an Online Intervention for Major Depressive Disorder in Cancer Patients
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. Department of Psychology Undergraduate Research Theses; 2018
Background: Major depressive disorder (MDD) is the most prevalent psychiatric disorder among cancer patients. There are currently no specific treatments for cancer patients with MDD. Cancer patients may be burdened by medical appointments, symptoms from cancer, and cancer treatment which may limit accessibility to conventional CBT. A convenient, accessible, and self-paced treatment such as computerized cognitive behavioral therapy (cCBT) may be suitable for patients with cancer, as cCBT has been proven to be both effective and efficacious. Although cCBT is effective in treating depression, treatment adherence has been a major limitation. Thus, the proposed study will examine treatment adherence, differences between adherent and non-adherent treatment groups, and factors that contribute to dropout in cCBT for cancer. Study aims are: (1) To compare psychosocial functioning, physical symptoms, and demographics of adherent and non-adherent groups. (2) To examine qualitative reasons for non-adherence. Methods: A sample of 31 cancer patients enrolled in a randomized waitlist control trial. Patients completed online self-report measures assessing depression (PHQ9, BDI-II), anxiety (GAD – 7), mood (POMS), coping (Brief COPE), impact of cancer (IES), physical symptoms (FSI, PSQI, SF-36), and demographics at baseline. To examine differences in adherence groups, independent samples t tests and Chi-square tests were completed. Semi-structured interviews over the phone were conducted with patients defined as "non-adherent". Patients' adherence related to program content, accessibility, and health concerns were assessed. Results: Non-adherent patients had higher PHQ-9 scores (M = 13. 21, SD = 5. 50) compared to adherent patients (M = 10.08, SD = 2.97; t(31) = 2. 05, p = 0. 05). There was a significant relationship between adherence and a previous major depressive episode, X^2 (1, N = 31) = 5.985, p< .025. All other self-report measures and demographic characteristics were non-associated. Qualitative data demonstrate factors contributing to dropout focus on time constraints and negative life events (e. g. loss of job, family conflict). Discussion: Analyses demonstrate that cCBT may be best for cancer patients with mild to moderate depression, as patients with higher PHQ-9 scores were more likely to be non-adherent to cCBT. Identifying barriers to treatment adherence could help inform and optimize future online treatments for cancer patients.
Academic Major: Neuroscience
Pelotonia Undergraduate Research Fellowship