随机临床试验：治疗性音乐视频干预对接受造血干细胞移植的青少年/年轻人韧性结果的影响：来自儿童肿瘤学组的报告。
Randomized clinical trial of therapeutic music video intervention for resilience outcomes in adolescents/young adults undergoing hematopoietic stem cell transplant: a report from the Children's Oncology Group.
机构信息
Indiana University School of Nursing, Indianapolis, Indiana.
出版信息
Cancer. 2014 Mar 15;120(6):909-17. doi: 10.1002/cncr.28355. Epub 2014 Jan 27.
BACKGROUND
To reduce the risk of adjustment problems associated with hematopoietic stem cell transplant (HSCT) for adolescents/young adults (AYAs), we examined efficacy of a therapeutic music video (TMV) intervention delivered during the acute phase of HSCT to: 1) increase protective factors of spiritual perspective, social integration, family environment, courageous coping, and hope-derived meaning; 2) decrease risk factors of illness-related distress and defensive coping; and 3) increase outcomes of self-transcendence and resilience.
METHODS
This was a multisite randomized, controlled trial (COG-ANUR0631) conducted at 8 Children's Oncology Group sites involving 113 AYAs aged 11-24 years undergoing myeloablative HSCT. Participants, randomized to the TMV or low-dose control (audiobooks) group, completed 6 sessions over 3 weeks with a board-certified music therapist. Variables were based on Haase's Resilience in Illness Model (RIM). Participants completed measures related to latent variables of illness-related distress, social integration, spiritual perspective, family environment, coping, hope-derived meaning, and resilience at baseline (T1), postintervention (T2), and 100 days posttransplant (T3).
RESULTS
At T2, the TMV group reported significantly better courageous coping (Effect Size [ES], 0.505; P = .030). At T3, the TMV group reported significantly better social integration (ES, 0.543; P = .028) and family environment (ES, 0.663; P = .008), as well as moderate nonsignificant effect sizes for spiritual perspective (ES, 0.450; P = .071) and self-transcendence (ES, 0.424; P = .088).
CONCLUSIONS
The TMV intervention improves positive health outcomes of courageous coping, social integration, and family environment during a high-risk cancer treatment. We recommend the TMV be examined in a broader population of AYAs with high-risk cancers.
背景
为降低青少年/年轻成人（AYA）造血干细胞移植（HSCT）相关调整问题的风险，我们研究了在 HSCT 急性期期间提供治疗性音乐视频（TMV）干预的疗效，以：1）增加精神视角、社会融合、家庭环境、勇敢应对和希望衍生意义的保护因素；2）降低疾病相关困扰和防御应对的风险因素；3）增加自我超越和韧性的结果。
方法
这是一项在 8 个儿童肿瘤学组（COG）地点进行的多站点随机对照试验（COG-ANUR0631），涉及 113 名年龄在 11-24 岁之间接受清髓性 HSCT 的 AYA。参与者随机分配到 TMV 或低剂量对照组（有声读物），与 board-certified 音乐治疗师一起完成 3 周内的 6 次课程。变量基于 Haase 的疾病适应模型（RIM）。参与者在基线（T1）、干预后（T2）和移植后 100 天（T3）完成与疾病相关困扰、社会融合、精神视角、家庭环境、应对、希望衍生意义和韧性的潜在变量相关的测量。
结果
在 T2 时，TMV 组报告的勇敢应对明显更好（效应量 [ES]，0.505；P=0.030）。在 T3 时，TMV 组报告的社会融合（ES，0.543；P=0.028）和家庭环境（ES，0.663；P=0.008）明显更好，以及精神视角（ES，0.450；P=0.071）和自我超越（ES，0.424；P=0.088）的中度非显著效应量。
结论
TMV 干预改善了高危癌症治疗期间勇敢应对、社会融合和家庭环境的积极健康结果。我们建议在更广泛的高危癌症 AYA 人群中检查 TMV。
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