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Psychoeducational Intervention for Patients With Cutaneous Malignant Melanoma: A Replication Study

From the Institute of Cancer Epidemiology, Danish Cancer Society; Department of Plastic Surgery and Burn Unit, Rigshospitalet, University of Copenhagen, Copenhagen; Department of Plastic Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej, Copenhagen County; and Department of Plastic and Reconstructive Surgery, Roskilde University Hospital, Roskilde, Denmark

Address reprint requests to Ellen H. Boesen, MSc, PhD, Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark; e-mail: ellen{at}cancer.dk

PURPOSE: In 1993, a randomized intervention study among patients with malignant melanoma showed a significant decrease in psychological distress and increased coping capacity 6 months after the intervention and enhanced survival 6 years later. We applied a similar intervention with a few modifications in a randomized controlled trial among Danish patients with malignant melanoma and evaluated results on immediate and long-term effects on psychological distress and coping capacity.

PATIENTS AND METHODS: A total of 262 patients with primary cutaneous malignant melanoma were randomly assigned to the control or intervention group. Patients in the intervention group were offered six weekly sessions of 2 hours of psychoeducation, consisting of health education, enhancement of problem-solving skills, stress management, and psychological support. The participants were assessed at baseline before random assignment and 6 and 12 months after surgery. The analyses of the main effects of the intervention were based on analyses of covariance.

RESULTS: The patients in the intervention group showed significantly less fatigue, greater vigor, and lower total mood disturbance compared with the controls, and they used significantly more active-behavioral and active-cognitive coping than the patients in the control group. The improvements were only significant at first follow-up.

CONCLUSION: The findings of this study support the results of an earlier intervention study among patients with malignant melanoma and indicate that a psychoeducational group intervention for such patients can decrease psychological distress and enhance effective coping. However, this effect is short term and the clinical relevance is not obvious.

Supported by the Psychosocial Research Committee, The Danish Cancer Society (9722559 and PP01016), and the IMK Foundation (5322569).

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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