School of Psychology, Flinders University, Adelaide, SA.
Med J Aust. 2010 Sep 6;193(S5):S68-73. doi: 10.5694/j.1326-5377.2010.tb03932.x.
To evaluate the efficacy of an interactive self-help workbook in reducing distress, and improving quality of life (QOL) and coping for women recently diagnosed with breast cancer.
Randomised controlled trial comparing the use of the workbook and that of an information booklet.
49 women with Stage 0 to II breast cancer diagnosed in the previous month and recruited from 1 February 2007 to 1 February 2008, in two urban Australian public hospitals.
The primary outcome measures were depression, anxiety, and posttraumatic stress. Secondary outcomes included QOL, body image, and the coping styles helplessness/hopelessness, cognitive avoidance and anxious preoccupation.
After controlling for baseline levels, interactions at 3-month follow-up showed that participants in the workbook group had significantly lower levels of posttraumatic stress (F[1,89] = 7.01; P = 0.01), helplessness/hopelessness (F [1,89] = 4.75; P = 0.03), and cognitive avoidance (F [1,89] = 4.95; P = 0.03) than those in the control (information booklet) group. However, women in the workbook group had significantly poorer body image than those in the control group (F [1,89] = 6.43; P = 0.01). At 6 months, only the body image interaction remained significant (F [1,93] = 7.44; P = 0.01).
These results suggest that a self-help workbook can be an effective, short-term intervention for improving posttraumatic stress, cognitive avoidance, and certain depressive symptoms in women recently diagnosed with breast cancer. However, issues related to body image need to be dealt with differently.
Australian New Zealand Clinical Trials Registry
评估互动自助手册对减轻近期诊断为乳腺癌的女性的痛苦、提高生活质量（QOL）和应对能力的疗效。
比较使用手册和信息手册的随机对照试验。
49 名 0 期至 2 期乳腺癌患者，于 2007 年 2 月 1 日至 2008 年 2 月 1 日在澳大利亚两家城市公立医院招募。
主要观察指标为抑郁、焦虑和创伤后应激。次要结果包括 QOL、身体形象和应对方式无助/绝望、认知回避和焦虑专注。
在控制基线水平后，3 个月随访时的交互作用显示，手册组患者的创伤后应激（F[1,89] = 7.01；P = 0.01）、无助/绝望（F[1,89] = 4.75；P = 0.03）和认知回避（F[1,89] = 4.95；P = 0.03）水平显著低于对照组（信息手册）。然而，手册组女性的身体形象明显不如对照组（F[1,89] = 6.43；P = 0.01）。6 个月时，只有身体形象的交互作用仍然显著（F[1,93] = 7.44；P = 0.01）。
这些结果表明，自助手册可以成为一种有效的短期干预手段，用于改善近期诊断为乳腺癌的女性的创伤后应激、认知回避和某些抑郁症状。然而，与身体形象相关的问题需要以不同的方式处理。
澳大利亚新西兰临床试验注册
