Boesen, E. H., Ross, L., Frederiksen, K., Thomsen, B. L., Dahlstrøm, K., Schmidt, G., . . . Johansen, C. (2005). Psychoeducational intervention for patients with cutaneous malignant melanoma: a replication study. Journal of Clinical Oncology, 23, 1270–1277.

A psychoeducational intervention was offered between three weeks and four months postsurgery for malignant melanoma to groups of 8 to 10 patients. The intervention was organized into six sessions lasting approximately 2.5 hours each and was performed over a six-week period. The intervention consisted of health education about malignant melanoma and follow-up routines, the importance of limiting sun exposure, stress awareness, and stress management (relaxation and guided imagery). Patients were given a workbook and a CD with relaxation and imagery exercises. Psychological support was provided via the presence of a group therapist throughout all sessions and through peer support in the group setting.

• In total, 262 patients with T1-4, N1a-2a, M0 malignant melanoma were recruited between 3 and 12 weeks postsurgery.
• No follow-up data on these patients were available.
• There were no significant differences between the treatment and control groups relative to any demographic or medical variables.
• The majority of the patients in both groups were married and between ages 40 and 60 years.

• Multisite
• Outpatient oncology clinics in eastern Denmark

Patients were undergoing the long-term follow-up phase of care.

The study was a randomized, controlled trial with a usual care control group. Fatigue was evaluated at baseline prior to the intervention and at 6 and 12 months postintervention.

Profile of Mood States (POMS)

Controlling for baseline levels of fatigue, there was a statistically significant effect of the intervention on fatigue six months postintervention. This effect was not sustained at 12-month follow-up. Sixteen patients dropped out of the intervention before it started or after one session. All patients who dropped out cited that they dropped out due to the time or the distance involved or that they felt no need for support.

• The study lacked an attentional control group.
• Sixteen patients dropped out of the intervention.
• The direction of the bias on the intervention effect on fatigue (i.e., overestimation of the effect versus underestimation of the effect) created by these drop-outs was not examined/reported.
• Professional training was required to deliver the intervention.

Efficiencies of treatment were achieved through the group intervention modality.