Krischer Mindy M, Xu Ping, Meade Cathy D, Jacobsen Paul B
Department of Pediatrics, University of South Florida and the Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.
J Clin Oncol. 2007 Oct 10;25(29):4657-62. doi: 10.1200/JCO.2006.09.0126. Epub 2007 Sep 17.
This study sought to continue research on psychosocial interventions for patients being treated with radiation therapy across multiple centers and to replicate positive findings of a single-center study of patients being treated with chemotherapy. The primary objective of this study was to determine if a stress management intervention was effective in improving quality of life and decreasing psychological distress in patients undergoing radiotherapy for cancer.
A total of 310 patients about to begin radiotherapy treatment were randomly assigned to receive usual care only or self-administered stress management training. Quality-of-life assessments occurred at baseline and for 3 weeks after the beginning of radiotherapy treatment.
Overall, patients assigned to receive stress management training did not report significantly less psychological distress on the Medical Outcomes Study 36-Item Short Form (SF-36) Mental Component Summary Scale than did those assigned to usual care. When divided into subgroups based on the SF-36 Mental Component Summary Scale scores immediately after their first radiotherapy treatment, patients with above-average levels of psychological distress (scores < or = 50) who were randomly assigned to the intervention condition reported significant improvement in their distress compared with those assigned to usual care only on the SF-36 Mental Health Subscale and the Center for Epidemiologic Studies Depression Scale.
This study found that self-administered stress management training is effective only in those radiotherapy patients with initially higher levels of psychological distress. Additional research should examine the benefits of stress management training targeted specifically to patients experiencing heightened distress.
本研究旨在继续开展针对多中心接受放射治疗患者的心理社会干预研究,并重复一项针对接受化疗患者的单中心研究的阳性结果。本研究的主要目的是确定压力管理干预措施是否能有效改善癌症放疗患者的生活质量并减轻其心理困扰。
共有310名即将开始放疗的患者被随机分配,分别仅接受常规护理或接受自我管理的压力管理培训。在基线时以及放疗开始后的3周内进行生活质量评估。
总体而言,被分配接受压力管理培训的患者在医学结局研究简明健康调查问卷(SF - 36)心理成分汇总量表上报告的心理困扰程度,与被分配接受常规护理的患者相比,并没有显著降低。根据首次放疗后立即获得的SF - 36心理成分汇总量表评分将患者分为亚组后,心理困扰水平高于平均水平(评分≤50)且被随机分配到干预组的患者,与仅被分配接受常规护理的患者相比,在SF - 36心理健康子量表和流行病学研究中心抑郁量表上,其困扰程度有显著改善。
本研究发现,自我管理的压力管理培训仅对初始心理困扰水平较高的放疗患者有效。进一步的研究应考察专门针对困扰程度较高患者的压力管理培训的益处。