Coping with checkpoint inhibitor adverse events: Assisting cancer patients in skills development - insights from the Immuno'Act© pre-experimental pilot study.

Streel, Sylvie; Kirkove, Delphine; Gagnayre, Rémi; Rorive, Andrée; Freres, Pierre; Gennigens, Christine; UCCELLO, Sabrina; Evrard, Vanina; Greco, Véronica; CAMPOS CORRAL, Irène; Seidel, Laurence; Sibille, Anne; PAULUS, Astrid; Pétré, Benoît; Jerusalem, Guy

doi:10.1016/j.pec.2026.109537

Article (Scientific journals)

Coping with checkpoint inhibitor adverse events: Assisting cancer patients in skills development - insights from the Immuno'Act© pre-experimental pilot study.

Streel, Sylvie; Kirkove, Delphine; Gagnayre, Rémi et al.

2026 • In Patient Education and Counseling, 147, p. 109537

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/341461

DOI
10.1016/j.pec.2026.109537

PubMed
41689950

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Keywords :

Coping skills; Decision making; Immune checkpoint inhibitors; Immune-related adverse events; Neoplasms; Self efficacy; Therapeutic patient education

Abstract :

[en] [en] OBJECTIVES: Immune checkpoint inhibitors (ICIs) can lead to immune-related adverse events (irAEs), which can be severe if not promptly identified and managed. The therapeutic education tool Immuno'Act© has been created to teach cancer patients how to handle irAEs. This study aimed to assess: (1) the preliminary effects of the therapeutic patient education (TPE) session using Immuno'Act© on perceived self-efficacy (PSE), (2) the association between PSE and patients' decision-making to cope with health events, and (3) patients' acceptance of the tool. METHODS: This pre-experimental study included cancer patients treated with ICIs at the CHU of Liège, recruited by convenience. PSE was measured using an adapted self-administered questionnaire at least three weeks before the TPE session (T0), immediately afterwards (T1) and at least three weeks after T1 (T2). Decision-making was evaluated through patients' action choices in real-life scenarios presented in Immuno'Act©. Acceptance was assessed with brief scales covering perceived utility, ease of use, aesthetic aspects and overall judgment. Sociodemographic and clinical data were collected. Adjusted general linear mixed model evaluated PSE over time; adjusted linear and logistic regression models assessed associations with PSE changes and decision-making. Descriptive statistics summarised acceptance. RESULTS: Eighty patients participated. The PSE total score remained high throughout the study, with no effect from a single use of Immuno'Act© (p = 0.91). Up to 25 % of patients never chose the recommended action in coping with urgent and non-urgent irAEs. No association was observed between global PSE level and decision-making. Acceptance was rated positively by over 95 % of participants, with an overall judgment of 8.61 ± 0.96/10. CONCLUSION: The positive acceptance of Immuno'Act©, combined with concerning findings, underscores the need to integrate such tools into clinical practice to support patients in managing irAEs. PRACTICE IMPLICATIONS: Healthcare professionals should integrate tools like Immuno'Act© in routine care, with optimal implementation strategy to be determined.

Disciplines :

Oncology
Public health, health care sciences & services

Author, co-author :

Streel, Sylvie ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'oncologie médicale

Kirkove, Delphine ; Université de Liège - ULiège > Département des sciences de la santé publique

Gagnayre, Rémi; Lab. Education and Health Promotion, University Sorbonne Paris Nord, Villetaneuse, France

Rorive, Andrée ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'oncologie médicale

Freres, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'oncologie médicale

Gennigens, Christine ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'oncologie médicale

UCCELLO, Sabrina ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'oncologie médicale

Evrard, Vanina ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'oncologie médicale

Greco, Véronica ; Centre Hospitalier Universitaire de Liège - CHU > > Institut d'oncologie

CAMPOS CORRAL, Irène ; Centre Hospitalier Universitaire de Liège - CHU > > Institut d'oncologie

More authors (5 more)

^✱ These authors have contributed equally to this work.

Language :

English

Title :

Coping with checkpoint inhibitor adverse events: Assisting cancer patients in skills development - insights from the Immuno'Act© pre-experimental pilot study.

Publication date :

10 February 2026

Journal title :

Patient Education and Counseling

ISSN :

0738-3991

eISSN :

1873-5134

Publisher :

Elsevier BV, Ireland

Volume :

147

Pages :

109537

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S0738399126000704?httpAccept=text/xml

Available on ORBi :

since 15 February 2026

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Bibliography

Chhabra, N., Kennedy, J., A review of cancer immunotherapy toxicity: immune checkpoint inhibitors. J Med Toxicol 17 (2021), 411–424, 10.1007/s13181-021-00833-8.
Frères, P., Poncin, A., Lecocq, M., Immune-related adverse events. Rev Med Liege 76 (2021), 403–407.
Robert, C., A decade of immune-checkpoint inhibitors in cancer therapy. Nat Commun, 11, 2020, 3801, 10.1038/s41467-020-17670-y.
Grizzi, G., Petrelli, F., Ghidini, M., Ghidini, A., Ratti, M., Panni, S., et al. Immune-related adverse events (irAEs) and survival in solid tumors treated with immune checkpoint inhibitors (ICIs): a systematic review and meta-analysis. e14130–e14130 J Clin Oncol, 37, 2019, 10.1200/JCO.2019.37.15_suppl.e14130.
Hussaini, S., Chehade, R., Boldt, R.G., Raphael, J., Blanchette, P., Maleki Vareki, S., et al. Association between immune-related side effects and efficacy and benefit of immune checkpoint inhibitors - A systematic review and meta-analysis. Cancer Treat Rev, 92, 2021, 102134, 10.1016/j.ctrv.2020.102134.
Wood, L.S., Moldawer, N.P., Lewis, C., Immune checkpoint inhibitor therapy: key principles when educating patients. Clin J Oncol Nurs 23 (2019), 271–280, 10.1188/19.CJON.271-280.
White, L.L., Cohen, M.Z., Berger, A.M., Kupzyk, K.A., Swore-Fletcher, B.A., Bierman, P.J., perceived self-efficacy: a concept analysis for symptom management in patients with cancer. Clin J Oncol Nurs 21 (2017), E272–E279, 10.1188/17.CJON.E272-E279.
White, L.L., Cohen, M.Z., Berger, A.M., Kupzyk, K.A., Bierman, P.J., Self-efficacy for management of symptoms and symptom distress in adults with cancer: an integrative review. Oncol Nurs Forum 46 (2019), 113–128, 10.1188/19.ONF.113-128.
Lorig, K.R., Holman, H., Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med Publ Soc Behav Med 26 (2003), 1–7, 10.1207/S15324796ABM2601_01.
Bandura, A., Self-efficacy. 2000, Oxford University Press, New York, NY, US, Washington, DC, 10.1037/10522-094.
Hoffman, A.J., Enhancing self-efficacy for optimized patient outcomes through the theory of symptom self-management. Cancer Nurs 36 (2013), E16–E26, 10.1097/NCC.0b013e31824a730a.
Kruger, J., Dunning, D., Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments. J Pers Soc Psychol 77 (1999), 1121–1134, 10.1037//0022-3514.77.6.1121.
Schulz, P.J., Nakamoto, K., The perils of misinformation: when health literacy goes awry. Nat Rev Nephrol 18 (2022), 135–136, 10.1038/s41581-021-00534-z.
Bagnasco, A., Calza, S., Petralia, P., Aleo, G., Fornoni, L., Sasso, L., Investigating the use of Barrows Cards to improve self-management and reduce healthcare costs in adolescents with blood cancer: a pilot study. J Adv Nurs 72 (2016), 754–758, 10.1111/jan.12883.
Barrows, H.S., Tamblyn, R.M., The portable patient problem pack: a problem-based learning unit. Acad Med, 52, 1977, 1002.
Cohen, J., Statistical Power Analysis for the Behavioral Sciences, second ed., 1988, L. Erlbaum Associates, Hillsdale, N.J.
Aspiras, A., Power, N.J., Gonzalo, M.B., Survey analysis: assessing the needs of immunotherapy patients, caregivers, and health care providers. 135–135 J Clin Oncol, 36, 2018, 10.1200/JCO.2018.36.5_suppl.135.
Comité Régional d’Éducation pour la Santé (CRES). Comment mieux prendre en compte la littératie en santé des personnes en éducation thérapeutique ? 2021. 〈http://www.cres-paca.org/_depot_arkcms_crespaca/_depot_arko/articles/3309/fiche-synthep-litteratie_doc.pdf〉 (accessed August 30, 2022).
Wolf, M.S., Chang, C.-H., Davis, T., Makoul, G., Development and validation of the Communication and Attitudinal Self-Efficacy scale for cancer (CASE-cancer). Patient Educ Couns 57 (2005), 333–341, 10.1016/j.pec.2004.09.005.
Alexandre, B., Reynaud, E., Osiurak, F., Navarro, J., Acceptance and acceptability criteria: a literature review. Cogn Technol Work 20 (2018), 165–177, 10.1007/s10111-018-0459-1.
KCE - Belgian Health Care Knowledge Center. Position paper: organisation des soins pour les malades 2012. 〈https://kce.fgov.be/fr/publications/tous-les-rapports/position-paper-organisation-des-soins-pour-les-malades-chroniques-en-belgique〉 (accessed January 19, 2024).
Coolbrandt, A., Milisen, K., Wildiers, H., Aertgeerts, B., van Achterberg, T., Van der Elst, E., et al. A nursing intervention aimed at reducing symptom burden during chemotherapy (CHEMO-SUPPORT): a mixed-methods study of the patient experience. Eur J Oncol Nurs J Eur Oncol Nurs Soc 34 (2018), 35–41, 10.1016/j.ejon.2018.03.002.
Coolbrandt, A., Wildiers, H., Laenen, A., Aertgeerts, B., Dierckx de Casterlé, B., van Achterberg, T., et al. A Nursing intervention for reducing symptom burden during chemotherapy. Oncol Nurs Forum 45 (2018), 115–128, 10.1188/18.ONF.115-128.
Hoffman, A.J., Brintnall, R.A., Given, B.A., von Eye, A., Jones, L.W., Brown, J.K., Using perceived self-efficacy to improve fatigue and fatigability in postsurgical lung cancer patients: a pilot randomized controlled trial. Cancer Nurs 40 (2017), 1–12, 10.1097/NCC.0000000000000378.
Wibowo, E., Wassersug, R.J., Robinson, J.W., Santos-Iglesias, P., Matthew, A., McLeod, D.L., et al. An educational program to help patients manage androgen deprivation therapy side effects: feasibility, acceptability, and preliminary outcomes. Am J Mens Health, 14, 2020, 1557988319898991, 10.1177/1557988319898991.
Zhang, M., Chan, S.W., You, L., Wen, Y., Peng, L., Liu, W., et al. The effectiveness of a self-efficacy-enhancing intervention for Chinese patients with colorectal cancer: a randomized controlled trial with 6-month follow up. Int J Nurs Stud 51 (2014), 1083–1092, 10.1016/j.ijnurstu.2013.12.005.
Ruland, C.M., Andersen, T., Jeneson, A., Moore, S., Grimsbø, G.H., Børøsund, E., et al. Effects of an internet support system to assist cancer patients in reducing symptom distress: a randomized controlled trial. Cancer Nurs 36 (2013), 6–17, 10.1097/NCC.0b013e31824d90d4.
Mosher, C.E., Winger, J.G., Hanna, N., Jalal, S.I., Einhorn, L.H., Birdas, T.J., et al. Randomized pilot trial of a telephone symptom management intervention for symptomatic lung cancer patients and their family caregivers. J Pain Symptom Manag 52 (2016), 469–482, 10.1016/j.jpainsymman.2016.04.006.
Dunning, D., Heath, C., Suls, J.M., Flawed self-assessment: implications for health, education, and the workplace. Psychol Sci Public Interest J Am Psychol Soc 5 (2004), 69–106, 10.1111/j.1529-1006.2004.00018.x.
Power, T.E., Swartzman, L.C., Robinson, J.W., Cognitive-emotional decision making (CEDM): a framework of patient medical decision making. Patient Educ Couns 83 (2011), 163–169, 10.1016/j.pec.2010.05.021.
Kelly, M.P., Barker, M., Why is changing health-related behaviour so difficult?. Public Health 136 (2016), 109–116, 10.1016/j.puhe.2016.03.030.
Margat, A., Pétré, B., d'Ivernois, J.-F., Lombrail, P., Cailhol, J., Gagnayre, R., COVID-19: Proposition d'un modèle d’éducation d'urgence. Educ Thérapeutique Patient Ther Patient Educ, 12, 2020, 10402, 10.1051/tpe/2020003.
Stenberg, U., Vågan, A., Flink, M., Lynggaard, V., Fredriksen, K., Westermann, K.F., et al. Health economic evaluations of patient education interventions a scoping review of the literature. Patient Educ Couns 101 (2018), 1006–1035, 10.1016/j.pec.2018.01.006.