Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Klinikum rechts der Isar, Technische Universität München, Langerstr 3, 81675 Munich, Germany.
Support Care Cancer. 2010 Apr;18(4):471-9. doi: 10.1007/s00520-009-0696-1. Epub 2009 Oct 29.
This paper aims to evaluate the effects of two psychotherapeutic interventions on dysfunctional fear of progression (FoP) in cancer patients and to investigate illness-specific influences.
One hundred seventy-four cancer patients were recruited from two rehabilitation clinics and randomly assigned to either a four-session cognitive-behavioral group therapy or a supportive-experiential group therapy. The main outcome criterion was FoP that was assessed with the Fear of Progression Questionnaire (FoP-Q) directly before (T1) and after (T2) the intervention, as well as 3 (T3) and 12 months (T4) after discharge. Secondary outcomes were anxiety, depression, and quality of life that were assessed with the following questionnaires: Questions on Life Satisfaction, Questionnaire for General Health Status, and the Hospital Anxiety and Depression Scale. Patients from the control group (n = 91) who received treatment as usual were recruited 1 year later with the same inclusion criteria and assessed with the FoP-Q at T1, T2, and T4.
Analyses showed a significant main effect for time and a significant interaction for group x time for the main outcome variable. FoP decreased significantly over time in both intervention groups in contrast to the control group that showed only short-term improvements. The interventions were also effective in improving secondary outcomes except general life satisfaction. Analyses of cancer specific influences on FoP indicated a significant influence of disease status, i.e., patients with metastases and recurrence of cancer gained most from the interventions.
Fear of progression, one of the main sources of distress for cancer patients, can be reduced with short psychotherapeutic interventions.
本文旨在评估两种心理治疗干预对癌症患者功能失调性进展恐惧(FoP)的影响,并探讨疾病特异性影响。
从两家康复诊所招募了 174 名癌症患者,并将其随机分配至四节认知行为团体治疗或支持体验团体治疗组。主要结局指标为 FoP,采用 FoP 问卷(FoP-Q)在干预前(T1)、干预后(T2)以及出院后 3 个月(T3)和 12 个月(T4)进行评估。次要结局指标为焦虑、抑郁和生活质量,采用生活满意度问卷、一般健康状况问卷和医院焦虑抑郁量表进行评估。一年后,我们招募了来自对照组(n=91)的患者,他们接受了常规治疗,并在 T1、T2 和 T4 时使用 FoP-Q 进行评估。
分析显示,主要结局变量存在显著的时间主效应和组间 x 时间交互效应。与仅短期改善的对照组相比,两组的 FoP 均随时间显著降低。干预措施也能有效改善次要结局,除了一般生活满意度。对 FoP 的癌症特异性影响的分析表明,疾病状态具有显著影响,即患有转移和癌症复发的患者从干预中获益最多。
作为癌症患者主要困扰来源之一的进展恐惧,可以通过短期心理治疗干预来减轻。