Danish Cancer Society Research Center, Survivorship, Strandboulevarden 49, DK 2100 Copenhagen, Denmark.
Eur J Cancer. 2013 Apr;49(6):1365-73. doi: 10.1016/j.ejca.2012.10.030. Epub 2012 Dec 19.
As the incidence of and survival from breast cancer continue to raise, interventions to reduce anxiety and depression before, during and after treatment are needed. Previous studies have reported positive effects of a structured 8-week group mindfulness-based stress reduction program (MBSR) among patients with cancer and other conditions.
To test the effect of such a programme on anxiety and depression among women with breast cancer in a population-based randomised controlled study.
A total of 336 women who had been operated on for breast cancer (stage I-III) were randomised to usual care or MBSR+usual care. Questionnaires including the Symptom Checklist-90r anxiety and depression subscales and the Center for Epidemiological Studies-Depression scale were administered before randomisation and immediately, 6 and 12 months after the intervention.
Intention-to-treat analyses showed differences between groups in levels of anxiety (p=0.0002) and depression (SCL-90r, p<0.0001; CES-D, p=0.0367) after 12 months. Graphical comparisons of participants with higher levels of anxiety and depression at baseline showed a significantly greater decrease in the intervention group throughout follow-up and no differences among least affected participants. Medium-to-large effects were found for all outcomes in the intervention group in analyses of change scores after 12 months' follow-up.
The 8-week group based MBSR intervention had clinically meaningful, statistically significant effects on depression and anxiety after 12 months' follow-up, and medium-to-large effect sizes. Our findings support the dissemination of MBSR among women with breast cancer. (Clintrials.gov No.: NCT00990977).
随着乳腺癌发病率和生存率的不断提高,需要在治疗前、治疗中和治疗后采取干预措施来降低焦虑和抑郁。先前的研究报告了针对癌症和其他疾病患者的结构化 8 周团体正念减压方案(MBSR)的积极效果。
在一项基于人群的随机对照研究中,测试该方案对乳腺癌女性焦虑和抑郁的影响。
共招募了 336 名接受乳腺癌(I-III 期)手术的女性,随机分为常规护理组或 MBSR+常规护理组。在随机分组前和干预后即刻、6 个月和 12 个月,使用包括症状清单-90r 焦虑和抑郁分量表和流行病学研究中心抑郁量表在内的问卷进行评估。
意向治疗分析显示,12 个月后两组在焦虑水平(p=0.0002)和抑郁水平(SCL-90r,p<0.0001;CES-D,p=0.0367)上存在差异。对基线时焦虑和抑郁程度较高的参与者进行图形比较显示,干预组在整个随访过程中显著下降,而最不影响的参与者则没有差异。在 12 个月随访后的变化评分分析中,干预组的所有结局均发现中到大的效应。
8 周团体 MBSR 干预对 12 个月随访后的抑郁和焦虑具有临床意义和统计学意义的影响,且具有中到大的效应量。我们的研究结果支持在乳腺癌女性中推广 MBSR。(ClinicalTrials.gov 编号:NCT00990977)。