Gielissen M F M, Verhagen C A H H V M, Bleijenberg G
Expert Centre Chronic Fatigue Nijmegen, Radboud University Nijmegen Medical Centre, Nijmegen 6500 HB, The Netherlands.
Br J Cancer. 2007 Sep 3;97(5):612-8. doi: 10.1038/sj.bjc.6603899. Epub 2007 Jul 24.
An earlier randomised-controlled trial demonstrated the positive effects of cognitive behaviour therapy (CBT), especially designed for fatigued cancer survivors in reducing fatigue, functional impairments and psychological distress. In the current prospective study, we were able to examine the long-term effect of CBT in patients who completed the therapy. Predictors of fatigue severity at follow-up were exploratory investigated. Sixty-eight patients who completed CBT were assessed at pretreatment, post-treatment and at follow-up (mean follow-up 1.9 years (s.d. 1.0), range: 1-4 years). To analyse possible predictors of treatment outcome a linear regression (enter) was carried out. Improvements on fatigue severity, functional impairment and psychological distress after CBT appeared to remain stable during a follow-up period. Patients who were not fatigued anymore at follow-up were not different from a reference group of non-fatigued cancer survivors. The explorative regression analysis showed that fatigue severity, psychological distress and somatic attributions at pretreatment contributed to persistent fatigue severity at follow-up. Cognitive behaviour therapy, especially designed for post-cancer fatigue, is successful in reducing fatigue and functional impairment in cancer survivors. Moreover, these positive effects were maintained at about 2 years after finishing CBT.
一项较早的随机对照试验证明了专门为疲劳的癌症幸存者设计的认知行为疗法(CBT)在减轻疲劳、功能障碍和心理困扰方面的积极效果。在当前的前瞻性研究中,我们能够检验CBT对完成该疗法的患者的长期影响。对随访时疲劳严重程度的预测因素进行了探索性研究。对68名完成CBT的患者在治疗前、治疗后和随访时(平均随访1.9年(标准差1.0),范围:1 - 4年)进行了评估。为了分析治疗结果的可能预测因素,进行了线性回归(全进入法)。CBT后疲劳严重程度、功能障碍和心理困扰的改善在随访期间似乎保持稳定。随访时不再疲劳的患者与无疲劳的癌症幸存者对照组没有差异。探索性回归分析表明,治疗前的疲劳严重程度、心理困扰和躯体归因有助于随访时持续的疲劳严重程度。专门为癌症后疲劳设计的认知行为疗法在减轻癌症幸存者的疲劳和功能障碍方面是成功的。此外,这些积极效果在完成CBT后约2年时得以维持。