Efficacy of a Training Program for Long-Term Disease-Free Cancer Survivors as Health Partners: A Randomized Controlled Trial in Korea

  • Yun, Young Ho (Cancer Research Institute, Seoul National University Hospital and College of Medicine) ;
  • Lee, Myung Kyung (Department of Nursing, Dong-A University) ;
  • Bae, Yeonmin (Research Institute and Hospital, National Cancer Center) ;
  • Shon, Eun-Jung (Research Institute and Hospital, National Cancer Center) ;
  • Shin, Bo-Ram (Research Institute and Hospital, National Cancer Center) ;
  • Ko, Hyonsook (Coaching Management Institute, Seoul National University College of Medicine) ;
  • Lee, Eun Sook (Research Institute and Hospital, National Cancer Center) ;
  • Noh, Dong-Young (Cancer Research Institute, Department of Surgery, Seoul National University College of Medicine) ;
  • Lim, Jae-Young (Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Sung (Department of Surgery, Sungkyunkwan University School of Medicine) ;
  • Kim, Si-Young (Department of Internal Medicine, Kyung Hee University Hospital) ;
  • Cho, Chi-Heum (Department of Obstetrics and Gynecology, Keimyung University School of Medicine) ;
  • Jung, Kyung Hae (Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Chun, Mison (Department of Radiation Oncology, Ajou University School of Medicine) ;
  • Lee, Soon Nam (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Park, Kyong Hwa (Division of Medical Oncology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Chang, Yoon Jung (Research Institute and Hospital, National Cancer Center)
  • Published : 2013.12.31


Background: To determine whether the Health Partner Program is effective in training long-term cancer survivors to be health coaches. Materials and Methods: We randomly assigned cancer survivors who were selected through a rigorous screening process to either the Health Partner Program or the waiting-list control group. The program consisted of 8 weeks of training in health management, leadership, and coaching. At baseline, 8, and 16 weeks, we measured primary outcomes using the Seven Habit Profile (SHP), the Korean Leadership Coaching Competency Inventory (KCCI), Ed Diner's Satisfaction with Life Scale (SWLS), and the Posttraumatic Growth inventory (PTGI) and secondary outcomes using the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale-Revised (IES-R), and the Medical Outcomes Study (MOS) short form 36-item questionnaire (SF-36). Results: We recruited 70 subjects and randomly assigned 34 to the intervention group. The Sharpen the Saw habit of the SHP increased significantly more in intervention group than in the control group (p=0.049), as did most PTGI factors. The intervention group also showed a significantly greater enhancement of vitality (p=0.015) and mental health (p=0.049) SF-36 scores but no improvement in KCCI, SWLS, HADS, or IES-R scores. The intervention group also showed a greater clinically meaningful improvement in the "Think Win-Win" of SHP (p=0.043) and in the personal strength score (p=0.025) and total score (p=0.015) of the PTGI. Conclusions: Long-term cancer survivors can benefit from the Health Partner Program to become health coaches.


  1. Bodenheimer T (2008). Coordinating care--a perilous journey through the health care system. N Engl J Med, 358, 1064-71.
  2. Centers for Disease Control and Prevention (2004). A National Action Plan for Cancer Survivorship: Advancing Public Health Strategies. Atlanta, Georgia, U.S. Department of Health and Human Services.
  3. Cheung WY, Neville BA, Earle CC (2010). Associations among cancer survivorship discussions, patient and physician expectations, and receipt of follow-up care. J Clin Oncol, 28, 2577-83.
  4. Cohen J (1988). Statistical power analysis for the behavioral sciences, Lawrence Erlbaum.
  5. Covey SR (1991). The seven habits of highly effective people. Natl Med Leg J, 2, 8.
  6. Diener E, Emmons RA, Larsen RJ, et al (1985). The satisfaction with life scale. J Pers Assess, 49, 71-5.
  7. Ezat WP, Noraziani K, Sabrizan O (2012). Improving quality of life among cancer patients in Malaysia. Asian Pac J Cancer Prev, 13, 1069-75.
  8. Ganz PA, Hahn EE (2008). Implementing a survivorship care plan for patients with breast cancer. J Clin Oncol, 26, 759-67.
  9. Appel LJ, Clark JM, Yeh HC, et al (2011). Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med, 365, 1959-68.
  10. Bjelland I, Dahl AA, Haug TT, et al (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. J Psychosom Res, 52, 69-77.
  11. Grunfeld E, Earle CC (2010). The interface between primary and oncology specialty care: treatment through survivorship. J Natl Cancer Inst Monogr, 2010, 25-30.
  12. Grunfeld E, Levine MN, Julian JA, et al (2006). Randomized trial of long-term follow-up for early-stage breast cancer: a comparison of family physician versus specialist care. J Clin Oncol, 24, 848-55.
  13. Han CW, Lee EJ, Iwaya T, et al (2004). Development of the Korean version of Short-Form 36-Item Health Survey: health related QOL of healthy elderly people and elderly patients in Korea. Tohoku J Exp Med, 203, 189-94.
  14. Isikhan V (2010). Coping with stress in patients with advanced cancer. Asian Pac J Cancer Prev, 11, 81-92.
  15. Jemal A, Siegel R, Ward E, et al (2009). Cancer statistics, 2009. CA Cancer J Clin, 59, 225-49,
  16. Khatcheressian JL, Wolff AC, Smith TJ, et al (2006). American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol, 24, 5091-7.
  17. Kim SH, Kang S, Kim YM, et al (2010). Prevalence and predictors of anxiety and depression among cervical cancer survivors in Korea. Int J Gynecol Cancer, 20, 1017.
  18. Kinsey T, Jemal A, Liff J, et al (2008). Secular trends in mortality from common cancers in the United States by educational attainment, 1993-2001. J Natl Cancer Inst, 100, 1003-12.
  19. Korea Leadership Center. Korea Leadership Center Coaching Competency Inventory (KCCI),
  20. Lewis FM, Casey SM, Brandt PA, et al (2006). The enhancing connections program: pilot study of a cognitive-behavioral intervention for mothers and children affected by breast cancer. Psychooncology, 15, 486-97.
  21. Lim HK, Woo JM, Kim TS, et al (2009). Reliability and validity of the Korean version of the Impact of Event Scale-Revised. Compr Psychiatry, 50, 385-90.
  22. Miedema B, MacDonald I, Tatemichi S (2003). Cancer follow-up care. Patients' perspectives. Can Fam Physician, 49, 890-5.
  23. Moon SH, Lee DT, Son Y (2013). Adherence to health-related lifestyle behavior recommendations and association with quality of life among cancer survivors and age-matched controls in Korea. Asian Pac J Cancer Prev, 4, 2949-54.
  24. Morris BA, Shakespeare-Finch J, Scott JL (2011). Posttraumatic growth after cancer: the importance of health-related benefits and newfound compassion for others. Support Care Cancer, 20, 749-56.
  25. Motlagh H (2010). Impact of event scale-revised. J Physiother, 56, 203.
  26. Nangyeon L, Hwaryung LS. EM (2010). of the satisfaction With Life Scale(SWLS) findings in Korea. Korean J Psychol, 29, 21-47.
  27. Oh SM, Min KJ, Park DB (1999). A study on the standardization of the hospital anxiety and depression scale for Koreans: a comparison of normal, depressed and anxious groups. J Korean Neuropsychiatr Assoc, 38, 289-96.
  28. Parry C, Kent EE, Mariotto AB, et al (2011). Cancer survivors: a booming population. Cancer Epidemiol Biomarkers Prev, 20, 1996-2005.
  29. Paskett ED, Harrop JP, Wells KJ (2011). Patient navigation: an update on the state of the science. CA Cancer J Clin, 61, 237-49.
  30. Rosmawati NH (2010). Knowledge, attitudes and practice of breast self-examination among women in a suburban area in Terengganu, Malaysia. Asian Pac J Cancer Prev, 11, 1503-8.
  31. Tedeschi RG, Calhoun LG (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. J Trauma Stress, 9, 455-71.
  32. Vale MJ, Jelinek MV, Best JD, et al (2003). Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease. Arch Intern Med, 163, 2775.
  33. Ware Jr JE, Sherbourne CD (1992). The MOS 36-item shortform health survey (SF-36): I. Conceptual framework and item selection. Med Care, 30, 473-83.
  34. Zigmond AS, Snaith RP (1983). The hospital anxiety and depression scale. Acta Psychiatr Scand, 67, 361-70.

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