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21 December 2016

Partners of cancer patients satisfied with web-based self-help intervention

Twenty to thirty percent of the partners of cancer patients suffer from psychological problems. This percentage is even higher if the patients in question are terminally ill. With this in mind, scientists from the University of Twente’s Institute for Innovation and Governance Studies and VU University Medical Center have developed a web-based self-help intervention for people in this situation. Nadine Köhle’s PhD research showed that the partners involved were satisfied with the intervention, and that it helped them to cope better with their situation.

Dr Köhle was awarded her doctoral degree last week at the University of Twente.

Partners of cancer patients often neglect their own needs because they think that these are less important considering the severity of the health problems their sick partner is facing. Many of the partners experience complaints such as sleep problems, depression, fatigue, social isolation and anxiety. Nadine Köhle takes the view that this situation merits greater attention. “Several studies have shown that the partners need support.” However, the partners are usually fully occupied with care-related activities. Their main focus is the wellbeing of the patient. That is also why the web-based self-help intervention ‘Hold on, for each other’ was designed to enable the participants to follow it at a time that best suits them. Dr Köhle developed and evaluated the intervention during her PhD research. The intervention is based on approaches used in positive psychology (Acceptance and Commitment Therapy (ACT) and self-compassion). 


Her research reveals that the participants greatly appreciated the intervention. Eighty-five percent of respondents indicated that they were ‘satisfied’ to ‘very satisfied’ with the intervention. Over eighty percent indicated that the intervention helped them deal with the problems they were facing. Furthermore, nearly 85 percent were prepared to recommend the intervention to acquaintances who were in the same situation. It was also striking that almost seventy percent of the participants actually completed the intervention, which is a very high percentage for interventions of this kind. Nadine Köhle says “It’s great to see that the participants are satisfied. Having completed the intervention, they are now more aware of the situation in which they find themselves. The intervention also has a beneficial effect on their relationship with their partner. They feel even more connected. For us, it was great to see that the approaches on which the course is based have proved to be genuinely effective in practice. The processes of ACT and self-compassion are well suited to this particular problem.” 


In her research, Dr Köhle also explored various forms of supervision, to see which was best suited to the partners’ situation. For example, one group of participants received automated feedback, while another group received personal feedback from an online counsellor. In the long term, this latter variant seemed to be better at promoting recovery. However, based on her research, Nadine Köhle has not yet been able to reach any firm conclusions about which type and variant of the course is best. “More follow-up research is needed to determine that. However, the results do show that ‘Hold on, for each other’ certainly has the potential to support partners of cancer patients and reduce their psychological distress.”

“The intervention is also applicable (in a modified form) for other target groups,” the new PhD graduate adds. “These might include other informal carers of cancer patients, or the partners of patients suffering from a different chronic disease.” Researchers at the University Medical Center Utrecht are currently assessing if the intervention might also be suitable for partners of ALS patients.  


Nadine Köhle carried out her research at the Centre for eHealth and Wellbeing Research, which is part of the University of Twente’s Institute for Innovation and Governance Studies. She was supervised by Prof. Ernst Bohlmeijer (University of Twente), Prof. Irma Verdonck (VU University Medical Center Amsterdam), and Dr Stans Drossaert (University of Twente). Her research was partly funded by the Dutch Cancer Society and by the Alpe d’HuZes Foundation. On 15 December, Dr Köhle successfully defended her doctoral thesis.