J Clin Oncol:缓解癌症复发恐惧 这个心理干预方法有效吗?

2017-12-26 张琪 环球医学

2017年发表在《J Clin Oncol》的一项由澳大利亚和荷兰科学家进行的克服恐惧的随机试验,考察了一种针对癌症复发恐惧的新型心理社会干预的有效性。

2017年发表在《J Clin Oncol》的一项由澳大利亚和荷兰科学家进行的克服恐惧的随机试验,考察了一种针对癌症复发恐惧的新型心理社会干预的有效性。

目的:癌症复发恐惧(FCR)是普遍的、痛苦且持久的。本研究评估基于一种理论/经验的干预(ConquerFear)对FCR的影响。

方法:符合要求的存活者为患有可治愈的乳腺癌结肠癌或黑色素瘤、完成先前治疗(不包括内分泌疗法)2个月~5年、年龄>18岁,并且筛选时FCR问卷(FCRI)严重度亚量表的得分高于临床阈值。按1:1的比例将受试者随机分配至含5个模块的面对面的ConquerFear(注意力训练、认知、接受/平复、筛查行为和基于价值观的目标设定)或注意力控制(放松疗法)。在基线(T0)、治疗后(T1)和治疗后3个月(T2)和6个月(T3)时,受试者完成调查问卷。首要结局是FCRI总得分。

结果:来自17个站点和2个在线数据库的704名潜在的符合要求的存活者,533名是可联系的,其中222名(42%)同意;121名被随机分配至干预组,101名被分配至对照组。两组在基线时所有检测的特征是相同的。同对照组受试者相比,ConquerFear的受试者的FCRI总得分(P<0.001)和严重度的亚量表得分(P=0.001)从T0到T1具有临床和统计学意义的改善,这个改善在T2(P=0.017和P=0.023),FCRI总得分(P=0.018),仅在T3,从T0至T1的3个FCRI亚量表(0),以及一般性焦虑、癌症特异性焦虑(总的)和精神生活质量和元认知(总的)均有持续。FCRI心理困扰和癌症特异性困扰(总的)在T3仍存在显着差异。

结论:这项随机试验证实ConquerFear同注意力控制(放轻松)相比,能有效减少治疗后、3个月和6个月的FCRI总得分,以及治疗后许多次要结局。癌症特异性困扰(总的)在随访3个月和6个月时仍有较多的改善。

原始出处:
Butow PN, Turner J, Gilchrist J,et al.Randomized Trial of ConquerFear: A Novel, Theoretically Based Psychosocial Intervention for Fear of Cancer Recurrence.J Clin Oncol. 2017 Dec 20;35(36):4066-4077. doi: 10.1200/JCO.2017.73.1257. Epub 2017 Nov 2.

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    2018-07-06 minlingfeng
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    2017-12-27 120faa6em35(暂无昵称)

    癌症与恐惧有时如影随形.只是地方医院还是无法重视.如何推广还是荆棘重重

    0

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    2017-12-26 1e1b8538m79(暂无匿称)

    不错的文章不错的文章

    0

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    2017-12-26 方舒

    学习

    0

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