The BREATH study: Online self-management to facilitate adjustment after curative breast cancer.

After completion of curative treatment, all breast cancer patients go through the transition from patient to survivor. During this re-entry phase, patients are faced with a broad range of re-entry topics, concerning physical and emotional recovery, returning to work and fear of recurrence. The universality of these topics motivated the BREATH study to develop an effective and easily accessible self-management intervention to facilitate adjustment for all breast cancer patients. Therefore, the BREATH study aims to develop and establish the effectiveness of a web-based self-management intervention to facilitate adjustment after completion of primary curative breast cancer treatment. The question is whether this intervention compared with usual care is effective in decreasing psychological distress and/or increasing patient empowerment. Secondary outcomes include psychological, physical, and social measures. Tackling universal re-entry topics shortly after completion of primary breast cancer treatment might facilitate the transition from patient to survivor. The BREATH intervention provides a non-traditional psychological self-management approach to support emotional, physical and social recovery after breast cancer. The intervention is offered to all patients, both distressed and non-distressed. Innovative is the use of patients own strengths as an explicit intervention target providing a buffer to prevent psychological distress in long-term survivorship. At this moment, the (cost) effectiveness of the BREATH intervention is evaluated in a multicenter randomized controlled trial involving 7 hospitals in the Netherlands.

The purpose of this study is to develop a web-based intervention for breast cancer patients to reduce the impact of psychological problems that arise after the completion of medical treatment at an early stage. The research question is whether this intervention compared with usual care is effective in reducing psychological distress and/or improving empowerment.

Baseline (3 months after completion of radio and/or chemotherapy) and 4, 6 and 10 months after baseline.

The non-guided self-management BREATH intervention focuses on information and treatment of psychological problems (such as anxiety and depression), emotional processing issues, social problems (such as work resumption and reactions of the environment), and physical problems (such as pain, fatigue and sexuality), which can all be influenced by psychological factors. The intervention guides patients chronologically through universal re-entry topics. The protocol has a fixed structure that covers four months, representing four different phases of recovery after breast cancer. Each month has a fixed week structure that targets consecutively psycho-education, problems in every day live, social environment, and empowerment. Working ingredients include Information (25 scripts), Assignment (48 tasks), Assessment (10 tests) and Video (39 clips extracted from the recorded interviews).



The control group receives care as usual.