Leveraging Technology to Manage Psychological Distress

Stress associated with a diagnosis of cancer has been shown to induce considerable psychological morbidity, and 25–50 percent of all cancer patients indicate significant levels of distress. Two subgroups of patients exist within the 25–50 percent of individuals who evidence high distress: those who meet the criteria for psychiatric illnesses such as major depression or adjustment disorders (up to 25 percent of all patients) and patients who report distress levels that do not meet criteria for a psychiatric diagnosis but interfere significantly with quality of life and functional status (15–25 percent of all patients).

Even patients who do not meet criteria for a psychiatric diagnosis may experience worries, fears and other forms of psychological distress that impact daily functioning. Feelings of guilt, loss of control, anger, sadness and uncertainty are common in people with cancer. Further, cancer patients can face spiritual and existential issues involving faith, mortality and the meaning of death. Some cancer survivors report feelings of anger, isolation and diminished self-esteem in response to such stress.

Family members also have psychological needs. A cancer diagnosis for a family member creates fear and concern about the suffering that may be experienced. Caregiver psychological distress can be as severe as that of the person with cancer. Studies of psychological distress in both patients and their caregivers found that the psychological distress was parallel over time, although when the patient received treatment, caregivers experienced more distress than the patient. Thus, helping family members to manage their distress may have a beneficial effect on the quality of life for people with cancer.

Technology Solutions

All cancer patients, regardless of distress levels, need access to information because the effectiveness of psychosocial and educational interventions for the management of physical, emotional and social stressors in oncology is well documented. People who take part in psychosocial interventions report lower levels of depression and anxiety, as well as improved quality of life and treatment adherence. The use of technology to provide access to oncology patient education is still in its infancy, but some inroads have been made.

Videoconference technology (VT) is increasingly used to provide education regarding disease, treatment and sideeffect information for oncology patients and caregivers. Studies have shown VT-based education is equivalent to face-to-face education with regard to the amount of information retained and patient satisfaction with the delivery. Some studies reported increased patient knowledge after VT instruction because they were less anxious receiving the information outside the clinical setting. While most people with cancer prefer face-to-face education, VT allows patients and families to overcome issues such as transportation difficulties, rural isolation, caregiver isolation, lack of mobility and/or illness issues. VT allows cancer professionals to connect with hard-to-reach populations and provide them with the necessary disease and treatment education as well as psychosocial support. Increasing this accessibility helps patients improve their oncology health literacy, treatment adherence, treatment engagement and satisfaction and reduce anxiousness.

Support groups for people with cancer are an evidencebased intervention for dealing with the psychological and social effects of a cancer diagnosis and its treatment.