Cognitive thought diary in supportive psychology for people undergoing radiotherapy: A feasibility study

Background: Radiation therapy (RT) has become one of the most widely-used and efficient treatments for cancer; nevertheless, people who undergo radiotherapy suffer the physical and psychological consequences of this stressful treatment, in addition to the psychosocial distress related to cancer. However, a Radiotherapy Unit is often a place where several patients crowd in from various hospitals with restricted timetables and, for logistic reasons, it is not easy to provide regular psychological sessions for each one. It is important to find a setting that allows us the involvement of the largest number of patients referred to the unit. In this study, we aimed to evaluate the feasibility and the effect of a brief intervention of cognitive-oriented diary on the quality of life, anxiety and depressive symptoms of patients undergoing radiotherapy (RT), compared to a control group. METHODS: The sample was constituted of 68 experimental subjects and 78 controls, treated with RT. Both groups were assessed with the Toronto Alexithymia Scale (TAS-20), the Hamilton Anxiety and Depression Scale (HADS) and the EORTC-QLQ at the beginning and at the end of their RT. Experimental subjects were instructed to report emotions and thoughts before attending the RTsessions in a thought diary. RESULTS: The experimental group showed a good adherence to the diary, a reduction in mean scores of anxiety (P<0.001), depression (P<0.001), and alexithymia (P<0.001) together with an ameliorative effect on quality of life (P<0.014), compared to control group. CONCLUSIONS: We observed a reduction in alexithymia scores in the experimental group, together with a significant reduction in anxiety and depression symptoms and an improvement in quality of life, with a moderator role of social disparity in treatment adherence. Our outcomes suggest the opportunity to consider the diary an affordable and effective device for psychologists operating in RTunits, able to be extended to the majority of patients, in a simple and replicable setting.