School of Psychology, National University of Ireland, Galway, Ireland.
Br J Health Psychol. 2013 Sep;18(3):623-41. doi: 10.1111/bjhp.12009. Epub 2012 Dec 4.
This randomized controlled trial examines whether a briefer cognitive-behavioural (CBT) stress management intervention than the norm can reduce stress and distress and enhance benefit finding in women with breast cancer. It further aims to identify characteristics of those women most likely to benefit from the intervention.
A randomized controlled trial was conducted to assess the efficacy of a psychological intervention. Women (N = 355) who had undergone surgery for breast cancer 4 months earlier, the majority of whom were currently undergoing adjuvant therapy, completed questionnaires assessing global and cancer-specific stress, depression, anxiety, optimism and benefit finding. They were randomly assigned to a 5-week group cognitive-behavioural stress management (CBSM) programme plus standard care or standard care only. Reassessment occurred post-intervention and 12 months later.
Analyses of variance revealed that patients who received the intervention showed significant lowering of global stress and anxiety and increased benefit finding compared to controls. These differences, however, were not maintained at 12 months. Effects of the intervention were moderated by stress such that women with high global stress at baseline showed greater reduction in both stress and anxiety.
A CBSM intervention, which was briefer than the norm (5 weeks vs. 9-20 weeks), had beneficial effects on adjustment for women with breast cancer and was particularly effective for those with increased global stress. Screening on this basis may facilitate optimal and cost-effective psychological treatment.
本随机对照试验旨在研究，相较于常规时长的认知行为（CBT）压力管理干预，更简短的干预方案是否能减轻乳腺癌女性的压力和痛苦，并增强其益处发现。本研究还旨在确定最有可能从干预中受益的女性的特征。
进行了一项随机对照试验，以评估心理干预的效果。355 名女性在 4 个月前接受了乳腺癌手术，大多数人正在接受辅助治疗，她们完成了评估总体和癌症特异性压力、抑郁、焦虑、乐观和益处发现的问卷。她们被随机分配到为期 5 周的团体认知行为压力管理（CBSM）方案加标准护理或仅接受标准护理。在干预后和 12 个月后进行了重新评估。
方差分析显示，与对照组相比，接受干预的患者总体压力和焦虑显著降低，益处发现增加。然而，这些差异在 12 个月时并未维持。干预的效果受到压力的调节，即基线时总体压力较高的女性在压力和焦虑方面的降低更为明显。
相较于常规时长（9-20 周）更简短的 CBSM 干预方案对乳腺癌女性的适应有积极影响，对压力较大的女性尤其有效。基于此进行筛查可能有助于实现最佳和具有成本效益的心理治疗。
