乳腺癌简短认知行为与放松训练干预：一项随机对照试验。
Brief cognitive-behavioral and relaxation training interventions for breast cancer: A randomized controlled trial.
作者信息
Gudenkauf Lisa M, Antoni Michael H, Stagl Jamie M, Lechner Suzanne C, Jutagir Devika R, Bouchard Laura C, Blomberg Bonnie B, Glück Stefan, Derhagopian Robert P, Giron Gladys L, Avisar Eli, Torres-Salichs Manuel A, Carver Charles S
机构信息
Department of Psychology, University of Miami.
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine.
出版信息
J Consult Clin Psychol. 2015 Aug;83(4):677-688. doi: 10.1037/ccp0000020. Epub 2015 May 4.
OBJECTIVE
Women with breast cancer (BCa) report elevated distress postsurgery. Group-based cognitive-behavioral stress management (CBSM) following surgery improves psychological adaptation, though its key mechanisms remain speculative. This randomized controlled dismantling trial compared 2 interventions featuring elements thought to drive CBSM effects: a 5-week cognitive-behavioral training (CBT) and 5-week relaxation training (RT) versus a 5-week health education (HE) control group.
METHOD
Women with stage 0-III BCa (N = 183) were randomized to CBT, RT, or HE condition 2-10 weeks postsurgery. Psychosocial measures were collected at baseline (T1) and postintervention (T2). Repeated-measures analyses of variance (ANOVAs) tested whether CBT and RT treatments improved primary measures of psychological adaptation and secondary measures of stress management resource perceptions from pre- to postintervention relative to HE.
RESULTS
Both CBT and RT groups reported reduced depressive affect. The CBT group reported improved emotional well-being/quality of life and less cancer-specific thought intrusions. The RT group reported improvements on illness-related social disruption. Regarding stress management resources, the CBT group reported increased reliability of social support networks, while the RT group reported increased confidence in relaxation skills. Psychological adaptation and stress management resource constructs were unchanged in the HE control group.
CONCLUSIONS
Nonmetastatic breast cancer patients participating in 2 forms of brief, 5-week group-based stress management intervention after surgery showed improvements in psychological adaptation and stress management resources compared with an attention-matched control group. Findings provide preliminary support suggesting that using brief group-based stress management interventions may promote adaptation among nonmetastatic breast cancer patients.
目的
乳腺癌（BCa）女性患者术后常报告有更高的痛苦程度。术后基于小组的认知行为压力管理（CBSM）可改善心理适应能力，但其关键机制仍具推测性。本随机对照拆解试验比较了两种具有被认为可推动CBSM效果的要素的干预措施：为期5周的认知行为训练（CBT）和为期5周的放松训练（RT），与为期5周的健康教育（HE）对照组进行对比。
方法
0-III期BCa女性患者（N = 183）在术后2-10周被随机分配至CBT、RT或HE组。在基线期（T1）和干预后（T2）收集社会心理测量指标。重复测量方差分析（ANOVA）测试了CBT和RT治疗相对于HE组从干预前到干预后是否改善了心理适应的主要指标以及压力管理资源认知的次要指标。
结果
CBT组和RT组均报告抑郁情绪减轻。CBT组报告情绪幸福感/生活质量得到改善，且与癌症相关的思维侵扰减少。RT组报告在与疾病相关的社会干扰方面有所改善。关于压力管理资源，CBT组报告社会支持网络的可靠性增加，而RT组报告放松技能的信心增强。HE对照组的心理适应和压力管理资源结构未发生变化。
结论
与注意力匹配的对照组相比，非转移性乳腺癌患者在术后参与两种形式的为期5周的简短小组压力管理干预后，心理适应和压力管理资源得到改善。研究结果提供了初步支持，表明使用简短的小组压力管理干预可能促进非转移性乳腺癌患者的适应。
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