Online counseling via e-mail for breast cancer patients on the German internet: preliminary results of a psychoeducational intervention

Objectives: The internet offers new possibilities in psychosocial patient care. However, empirical data are lacking for oncological patients. A field-experimental study was conducted to obtain initial data to enable evaluation of the effectiveness of online counseling via e-mail for breast cancer patients. A secondary objective was to explore how patients reached by the service can be characterized on psychosocial status and illness. Methods: On a dedicated German-language website, 235 breast cancer patients registered for psychosocial counseling via e-mail. 133 registrants were randomly assigned to a treatment group to receive immediate counseling or to a waiting list control group. The two-month counseling session took the form of a psychoeducation, individually tailored to each patient. Psychosocial outcome measures including psychological distress (BSI) and quality of life (EORTC QLQ-C30) were assessed at registration and at a two-month follow-up. Descriptive data were recorded at registration. At the conclusion of the program, participants were asked to complete a patient satisfaction questionnaire (ZUF-8). Results: BSI responses showed that 85% of all patients were initially diagnosable with comorbid psychopathology. Despite high severity of distress and attendant large reductions in quality of life, 72% of all patients were not obtaining conventional assistance. Among counseling participants (n=31), no significant improvements in distress or quality of life were found in comparison to the control group (n=34), but patient satisfaction was nonetheless high. Conclusion: The study demonstrates that online counseling via e-mail reaches patients with unmet therapeutic needs, but also indicated its limitations, suggesting that the online setting may be most useful for prompting and supporting a transition to conventional counseling services.