Ross Lone, Rottmann Nina, Andersen Klaus K, Hoybye Mette T, Johansen Christoffer, Dalton Susanne O
The Research Unit, Department of Palliative Medicine, Bispebjerg/Frederiksberg Hospital, University of Copenhagen , Copenhagen NV , Denmark.
Acta Oncol. 2015 May;54(5):735-42. doi: 10.3109/0284186X.2014.998278. Epub 2015 Mar 9.
In 2002, the Danish Cancer Society opened a rehabilitation centre in which cancer patients were offered a free, six-day, multidimensional residential course. Our previous studies of the effects of this course at one and six months of follow-up showed no positive effect on distress. We investigated long-term effects at 12 months of follow-up and whether subgroups with fewer psychosocial resources received more benefit from the intervention than patients with better resources.
In two Danish counties, 507 patients with breast, prostate, colon or rectum cancer diagnosed within the past two years who had completed primary treatment were randomised to a six-day, multidimensional residential rehabilitation course or to standard care. Of these, 208 patients received the allocated intervention and 244 received the allocated control condition and were included in the analyses. Patients in both groups completed questionnaires at baseline and at one, six and 12 months of follow-up, including the 'Profile of Mood States short form', the 'General Self-efficacy' scale and a question on emotional support. At 12 months of follow-up, 179 participants in the intervention group and 195 in the control group provided data.
No effect of the intervention was found on distress at 12 months of follow-up, even in subgroups with fewer psychosocial resources at baseline, i.e. greater baseline distress, poorer self-efficacy and less emotional support.
Multidimensional rehabilitation programmes may not be effective in the treatment of distress. During the past few decades, studies of psychotherapy or psycho-education in cancer patients have shown small to moderate effects. More focused rehabilitation programmes may be more effective.
2002年，丹麦癌症协会开设了一家康复中心，为癌症患者提供为期六天的免费多维度住院课程。我们之前对该课程在随访1个月和6个月时效果的研究表明，对痛苦感没有积极影响。我们调查了随访12个月时的长期效果，以及心理社会资源较少的亚组患者是否比资源较好的患者从干预中获益更多。
在丹麦的两个县，将507名在过去两年内被诊断患有乳腺癌、前列腺癌、结肠癌或直肠癌且已完成初始治疗的患者随机分为接受为期六天的多维度住院康复课程组或标准护理组。其中，208名患者接受了分配的干预措施，244名患者接受了分配的对照措施，并纳入分析。两组患者在基线时以及随访1个月、6个月和12个月时均完成了问卷调查，包括“情绪状态简表”、“一般自我效能感”量表以及一个关于情感支持的问题。在随访12个月时，干预组的179名参与者和对照组的195名参与者提供了数据。
在随访12个月时，未发现干预措施对痛苦感有影响，即使是在基线时心理社会资源较少的亚组中，即基线痛苦感更强、自我效能感更差且情感支持更少的亚组。
多维度康复计划可能对痛苦感的治疗无效。在过去几十年中，对癌症患者进行心理治疗或心理教育的研究显示出小到中等程度的效果。更有针对性的康复计划可能更有效。
