Exploration of experience and sustained engagement with a web-based cognitive rehabilitation intervention amongst patients with aggressive lymphoma: a qualitative sub-study

BACKGROUND: Cancer-related cognitive impairment (CRCI), a common side effect of cancer and its treatment, is characterised by difficulties in memory, attention and executive function. This qualitative sub-study was part of a single-site, parallel-group, pilot randomised controlled trial in which recruitment and retention exceeded our expectations. The aim was to explore participants' experience and motivation for sustained engagement with a web-based cognitive rehabilitation (eReCog) intervention amongst people with aggressive lymphoma who were self-reporting cognitive decline. METHODS: We used an inductive qualitative approach, conducting semi-structured interviews with fourteen participants. Interviews were recorded, transcribed and a reflexive thematic approach was used to describe and interpret key themes and sub-themes in the data. RESULTS: Fourteen interviews were completed. We extracted four themes describing participants experience and motivation for sustained engagement with eReCog. These included information needs, experience of participation, support and ease of use. Participants were motivated to engage to gain knowledge and strategies to manage their CRCI symptoms; they enjoyed the experience and felt validated via the online community created. Finally, they valued the additional support they received and appreciated the convenience and flexibility of the web-based program. CONCLUSIONS: Our findings show that engagement with eReCog was driven by perceived cognitive improvements, psychosocial benefits and accessibility. Addressing both cognitive and psychosocial needs is warranted in web-based rehabilitation to foster continued participation engagement. Web-based cognitive rehabilitation interventions should enhance accessibility and earlier integration into the cancer trajectory to optimise long-term survivorship care in people with haematological cancers should be considered. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN 12623000705684 on 30th June 2023.