Empowerment and quality of life in gynecological cancer survivors: Outcomes from a multicenter quasi‐experimental cohort study from Norway (the LETSGO trial)
Year: 2025
Type: article
Study design: Clinical Trial
Abstract: BACKGROUND: Increasing outpatient demands and unmet patient needs necessitate personalized follow-up care for cancer survivors. This study investigated whether a self-management-focused follow-up model improves empowerment and quality of life (QoL) in gynecological cancer survivors compared to standard follow-up. METHODS: Twelve Norwegian hospitals participated in this cohort study. Patients initiating routine follow-up after primary treatment were eligible and allocated to either intervention or standard care follow-up groups based on their treatment hospital. The intervention included nurse-led consultations using coaching techniques for education on symptom monitoring and healthy lifestyle, alternated with physician-led consultations and access to a mobile app. Standard follow-up consisted of physician-led consultations only. The primary outcome was change in patient empowerment over 12 months, measured with the self-monitoring and insight domain of the Health Education Impact Questionnaire (heiQ). Secondary outcomes included changes in remaining heiQ domains and QoL. Data were analyzed according to intention-to-treat principles using linear mixed effects models. RESULTS: Among 741 participants (intervention: 378, standard: 363), baseline characteristics were comparable. At 12 months, no significant differences were observed in self-monitoring and insight (Δ = 0.02 [95% confidence interval (CI), -0.04 to 0.08]; effect sizes [ES] = 0.29). However, health-directed activity (Δ = 0.15 [95% CI, 0.04-0.25]; ES = 0.15), emotional well-being (Δ = 0.12 [95% CI, 0.02-0.20]; ES = 0.15), social functioning (Δ = 5.2 [95% CI, 1.1-9.3]; ES = 0.41), and physical functioning (Δ = 2.5 [95% CI, 0.0-5.0]; ES = 0.20) were significantly more improved in the intervention group. CONCLUSION: Lifestyle and Empowerment Techniques in Survivorship of Gynaecologic Oncology follow-up did not significantly impact self-monitoring and insight, but positively influenced other survivorship domains, indicating its potential for enhancing self-management and QoL in gynecological cancer survivors.
Source: Cancer
DOI: 10.1002/cncr.70040
Authors: Ingvild Vistad, Mette Skorstad, Sveinung Berntsen, Ingrid Demmelmaier, Line Bjørge, Lonneke V. van de Poll‐Franse, Kristina Lindemann, Elisabeth Berge Nilsen, Ala Haug, Anne Gry Bentzen, Tonje Bohlin, Trine Stokstad, Tea Brummer, Astrid Liavaag, Sølvi Lomsdal, Anja Døssland Holstad, Milada C. Hagen
Institutions: University of Oslo, Sørlandet Sykehus, University of Bergen, Uppsala University, University of Agder, Haukeland University Hospital, Tilburg University, The Netherlands Cancer Institute, Oslo University Hospital, Stavanger University Hospital, Akershus University Hospital, University Hospital of North Norway, Sykehuset i Vestfold, Norwegian University of Science and Technology, St Olav's University Hospital, Østfold Hospital Trust, Sørlandet Hospital Arendal, Innlandet Hospital Trust, OsloMet – Oslo Metropolitan University
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
Funders: Kreftforeningen, Helse Sør-Øst RHF
Awards: G4360138254, G8377225372
OpenAlex ID: W4413055660