Empowerment and quality of life in gynecological cancer survivors: Outcomes from a multicenter quasi‐experimental cohort study from Norway (the LETSGO 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.