Identifying and Mobilizing Personal Resources to Improve Well-Being in Cancer Participants Using the CAERES Protocol

UniDistance Suisse

Status: Completed

Conditions: Post-Traumatic Growth, Psychological; Self Efficacy; Neoplasms (Cancer / Tumors); Cancer-related Fatigue; Affect (Mental Function); Depression; Anxiety

Treatments: Behavioral: CAERES (Cancer Auto-Evaluation of RESources) Psychosocial Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT07582666

CE3941 (Other Identifier)

BASEC-2021-01759

Details and patient eligibility

About

Cancer patients often experience emotional distress, fatigue, and reduced quality of life that may not be fully addressed by medical treatment alone. Research suggests that helping patients identify and mobilize their personal strengths and resources may support their psychological well-being. However, structured psychosocial interventions focused on personal resources have not been widely tested in cancer rehabilitation settings.

The goal of this clinical trial was to test the acceptability and feasibility of a 3-week psychosocial intervention designed to help adult cancer patients identify and mobilize their personal strengths to better cope with their illness. The intervention was based on the AERES tool (Auto-Evaluation des RESsources; in english : Resources Self-Assessment), a card-sorting instrument developed at the University of Lausanne for strength-based assessment in clinical populations.

The main questions it aimed to answer were:

• Was the CAERES (Cancer Auto-Evaluation of RESources) intervention acceptable and feasible for cancer patients undergoing oncological treatment or rehabilitation?
• Did the intervention positively affect emotional well-being, self-efficacy, posttraumatic growth, cancer-related fatigue, anxiety, depression, and satisfaction with care?

Researchers compared an immediate-intervention group with a waitlist control group (3-week delay before receiving the same intervention) to see if the intervention produced measurable effects on the targeted outcomes.

Participants:

• Completed an in-person AERES card-sorting session (1 to 2.5 hours) to identify personal strengths across three dimensions (personal qualities, hobbies and passions, and social/environmental resources)
• Received a personalized written report identifying a targeted resource to develop
• Engaged in a 3-week home-based reinforcement program with three weekly phone calls (15 minutes each) and three personalized written feedback reports
• Completed validated questionnaires at three time points (baseline, post-intervention, follow-up)

Recruitment was conducted at three sites in Italian-speaking Switzerland: the Rehabilitation Clinic of Novaggio (EOC/Ente Ospedaliero Cantonale), the Oncology Institute of Southern Switzerland (IOSI) in Bellinzona, and a private psycho-oncology practice in Lugano, with patient referrals supported by collaborating psycho-oncologists.

Full description

The CAERES protocol uses the Auto-Evaluation of RESources (AERES) tool, a standardized card-sorting instrument originally developed by Bellier-Teichmann and Pomini (2015) for psychiatric populations, and subsequently validated as a strengths assessment tool in clinical populations (Bellier-Teichmann, Golay & Pomini, 2018). This study represented the first adaptation of the AERES tool to oncology.

The AERES tool comprises 31 illustrated cards organized into three dimensions: personal qualities and characteristics (11 cards, including courage, gratitude, humor, perseverance), hobbies and passions (10 cards, including cooking, reading, physical activities, music), and social and environmental resources (10 cards, including family, friends, nature, healthcare professionals), plus 3 blank cards allowing individualized additions. The card-sorting procedure involves three successive sorts: participants first identify which resources are present in their lives, then evaluate each resource's contribution to their recovery on a 4-point scale, and finally select resources they wish to develop or strengthen during the reinforcement period. The AERES tool has demonstrated good psychometric properties in previous research and provides a structured, visual method for engaging participants in a strengths-based assessment that does not rely on traditional questionnaire formats.

Following the AERES card-sorting session, the investigator prepared a personalized written report identifying the targeted resource selected by the participant for development. This report was the basis for a 3-week home-based reinforcement program in which the participant engaged with the targeted resource through self-directed exercises and reflection.

During the reinforcement program, three weekly contacts were structured: at the end of each week, a 15-minute phone call took place between the investigator and the participant to gather feedback on the past week's experience. Each phone call was followed by a personalized written feedback report sent to the participant to support their progress and reinforce engagement with the targeted resource.

The intervention used a multimodal communication approach adapted to participant preferences and circumstances. Written reports and questionnaires were delivered through email, postal mail, or in-person delivery, depending on what was most accessible and comfortable for each participant. This pragmatic flexibility reflected the real-world conditions of oncological care in Italian-speaking Switzerland and aimed at maximizing participant retention.

A quasi-experimental waitlist control design was adopted because random allocation was not feasible given the recruitment constraints across the three sites. Participants were allocated to either an immediate-intervention arm or a waitlist control arm based on the timing of their entry into the study and their treatment scheduling. The waitlist control group received the same intervention after a 3-week delay, allowing for within-subject comparison and a partial control for time effects. This design preserved the pragmatic feasibility of the study in a real-world oncological setting while maintaining a comparison condition.

Outcome assessments were conducted at three measurement time points: at baseline (before any intervention), at 3 weeks after baseline (post-intervention for the immediate-intervention group, end of waiting period for the waitlist control group), and at 6 weeks after baseline (end of study, after the waitlist control group had also completed the intervention). All measures were administered in Italian, and adaptations to recall periods were made for some instruments to align with the 3-week intervention timeline.

Enrollment: 32 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Any type of cancer
• Age ≥18 years
• Currently undergoing or awaiting curative cancer treatment (chemotherapy, radiotherapy, and/or surgery), or in oncological rehabilitation/follow-up
• Life expectancy of at least one year
• Sufficient knowledge of Italian or French
• Written informed consent provided

Exclusion criteria

• Treatment completed more than two years prior to enrollment
• Advanced disease
• Cancer relapse during the study
• Diagnosis of major depression
• Cognitive impairment preventing adequate adherence to the protocol
• Insufficient knowledge of Italian or French to participate in counseling and assessment sessions

Trial design

Primary purpose: Supportive Care

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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32 participants in 2 patient groups

Arm1: AERES Group (Immediate Intervention)

Experimental group

Description:

Adult cancer patients receiving the CAERES psychosocial intervention immediately after baseline assessment. The 3-week intervention combines: (1) an initial in-person AERES assessment session (1.5-2.5 hrs) using a card-based tool to identify personal strengths and resources, followed by an initial personalized written report specifying the targeted resource to mobilize; (2) three weekly follow-up phone calls, each followed by a personalized written report. Outcomes assessed at baseline (pre-test, before any intervention), at 3 weeks after baseline (post-test 1, immediately after intervention completion), and at 6 weeks after baseline (post-test 2, end of study). Written materials and self-report questionnaires were delivered by email, postal mail, or in person, according to participant preference.

Treatment:

Behavioral: CAERES (Cancer Auto-Evaluation of RESources) Psychosocial Intervention

Arm 2: WL group (Waitlist Control Group)

Active Comparator group

Description:

Adult cancer patients placed on a 3-week waiting list before receiving the same CAERES psychosocial intervention as Arm 1 (initial in-person AERES session, initial personalized written report, three weekly phone calls each followed by a personalized written report). Outcomes assessed at baseline (pre-test 1, before any intervention), at 3 weeks after baseline (pre-test 2, end of waiting period), and at 6 weeks after baseline (post-test, immediately after delayed intervention completion). Written materials and self-report questionnaires were delivered by email, postal mail, or in person, according to participant preference. Group allocation was non-randomized, based on participants' availability and compatibility with oncological treatment schedule.

Treatment:

Behavioral: CAERES (Cancer Auto-Evaluation of RESources) Psychosocial Intervention