Reimagine: a randomized controlled trial of an online, symptom self-management curriculum among breast cancer survivors

Support Care Cancer. 2019 May;27(5):1775-1781. doi: 10.1007/s00520-018-4431-7. Epub 2018 Aug 27.

Abstract

Purpose: Chronic pain, depression, and fatigue are common effects resulting from the cancer experience; new interventions are needed. This study examined the effect of Reimagine, an online symptom self-management curriculum that teaches coping skills, on key outcomes.

Methods: Adult breast cancer survivors with chronic pain were recruited from the Army of Women volunteer registry for this randomized controlled trial and randomized 1:1 to Reimagine or usual care conditions. Electronic surveys collected demographic, clinical, and outcome data at baseline and 18 weeks post-intervention.

Results: Participants (N = 89) were mean age 56.7 ± 8.7 years; 67% married; 58% employed; mean years since diagnosis 8.2 ± 6.6; and 89% were in remission or cured of their breast cancer. There was a significant difference in the change in depression scores for treatment (M = - 1.7, SD = 4.5) and usual care (M = 0.3, SD = 3.8) conditions; t(85) = - 2.3, p = .03. Difference in the change in fatigue scores was significant for treatment (M = 4.8, SD = 9.0) and usual care (M = 1.2, SD = 6.6) conditions; t(87) = 2.2, p = .03. Most Reimagine users (94%) would recommend the curriculum to others.

Conclusions: These results suggest that Reimagine has an effect on depression and fatigue symptoms for breast cancer survivors. Online programs can be a feasible and effective alternative to in-person support. Additional research is recommended with larger and more diverse samples.

Keywords: Breast cancer survivors; Cancer survivorship; Chronic pain; Depression; Fatigue; Randomized controlled trial; Self care; Symptom management.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adaptation, Psychological
  • Breast Neoplasms / psychology
  • Breast Neoplasms / therapy*
  • Cancer Pain / psychology
  • Cancer Pain / therapy*
  • Cancer Survivors / psychology*
  • Cognitive Behavioral Therapy / methods*
  • Curriculum
  • Education, Distance / methods*
  • Fatigue / psychology
  • Fatigue / therapy
  • Female
  • Humans
  • Middle Aged
  • Palliative Care / methods
  • Patient Education as Topic / methods*
  • Quality of Life
  • Self-Management / education*
  • Self-Management / methods
  • Surveys and Questionnaires