Yanez Betina, McGinty Heather L, Mohr David C, Begale Mark J, Dahn Jason R, Flury Sarah C, Perry Kent T, Penedo Frank J
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Cancer. 2015 Dec 15;121(24):4407-15. doi: 10.1002/cncr.29658. Epub 2015 Sep 8.
The utility of psychosocial interventions in reducing symptom burden and improving health-related quality of life (HRQOL) for men with localized prostate cancer has been demonstrated. However, studies have yet to demonstrate the efficacy of interventions in advanced prostate cancer (APC). This study examined the feasibility, acceptability, and preliminary efficacy of a technology-assisted, 10-week, group-based psychosocial intervention for diverse men with APC.
The participants were 74 men (mean age, 68.84 years; non-Hispanic white, 57%; black, 40.5%) who were randomized to a cognitive-behavioral stress management (CBSM) treatment or health promotion (HP) attention-control condition. The participants were assessed at the baseline, weekly throughout the 10-week program, and 6 months after the baseline. Outcomes were assessed with the Patient-Reported Outcomes Measurement Information System along with established measures of HRQOL, CBSM intervention targets (eg, relaxation skills), and patient-reported acceptability.
Feasibility was demonstrated through good retention rates (>85%) and acceptable average attendance rates (>70%), and acceptability was demonstrated through very favorable weekly session evaluations (mean score, 4/5) and exit surveys (mean score, 3.6/4). Men randomized to the CBSM condition reported significant reductions (P < .05) in depressive symptoms and improvements in relaxation self-efficacy (P < .05) at the 6-month follow-up. CBSM participants reported trends for improvement in distress and functional well-being (P < .08) in comparison with those in the HP condition. Effect sizes ranged from medium (0.54) to large (1.87) and, in some instances, were clinically meaningful.
Technology-based CBSM interventions among diverse men with APC may be feasible, acceptable, and efficacious.
心理社会干预在减轻局限性前列腺癌男性患者的症状负担和改善健康相关生活质量（HRQOL）方面的效用已得到证实。然而，研究尚未证明干预措施对晚期前列腺癌（APC）的疗效。本研究探讨了一项为期10周、基于小组的技术辅助心理社会干预对不同APC男性患者的可行性、可接受性和初步疗效。
参与者为74名男性（平均年龄68.84岁；非西班牙裔白人占57%；黑人占40.5%），他们被随机分配到认知行为压力管理（CBSM）治疗组或健康促进（HP）注意力控制组。在基线、为期10周的项目期间每周以及基线后6个月对参与者进行评估。使用患者报告结果测量信息系统以及既定的HRQOL测量方法、CBSM干预目标（如放松技巧）和患者报告的可接受性来评估结果。
通过良好的保留率（>85%）和可接受的平均出勤率（>70%）证明了可行性，通过非常积极的每周课程评估（平均得分4/5）和退出调查（平均得分3.6/4）证明了可接受性。随机分配到CBSM组的男性在6个月随访时报告抑郁症状显著减轻（P < 0.05），放松自我效能感有所改善（P < 0.05）。与HP组相比，CBSM参与者在痛苦和功能幸福感方面有改善趋势（P < 0.08）。效应大小从中等（0.54）到较大（1.87）不等，在某些情况下具有临床意义。
基于技术的CBSM干预对不同的APC男性患者可能是可行、可接受且有效的。
