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一项基于多学科导师指导的项目“乳腺癌康复计划(BRBC)”对中国大陆女性乳腺癌幸存者的影响——一项随机对照、基于理论推导的干预试验。

Effect of a multidiscipline mentor-based program, Be Resilient to Breast Cancer (BRBC), on female breast cancer survivors in mainland China-A randomized, controlled, theoretically-derived intervention trial.

作者信息

Ye Zeng Jie, Liang Mu Zi, Qiu Hong Zhong, Liu Mei Ling, Hu Guang Yun, Zhu Yun Fei, Zeng Zhen, Zhao Jing Jing, Quan Xiao Ming

机构信息

College of Economics and Management, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong province, China.

The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong province, China.

出版信息

Breast Cancer Res Treat. 2016 Aug;158(3):509-22. doi: 10.1007/s10549-016-3881-1. Epub 2016 Jul 11.

DOI:10.1007/s10549-016-3881-1
PMID:27400910
Abstract

To reduce the risk of adjustment problems for breast cancer patients in mainland China, we examined the efficacy of a multidiscipline mentor-based program, Be Resilient to Breast Cancer (BRBC), delivered after breast surgery to (a) increase protective factors of social support, hope for the future, etc.; (b) decrease risk factors of Physical and Emotional Distress; and (c) increase outcomes of Resilience, Transcendence and Quality of Life (QOL). A multisite randomized controlled trial was conducted at 6 specialist cancer hospitals. 101 and 103 breast cancer patients were allocated to intervention group (IG) and control group (CG), respectively, and 112 general females (without breast cancer) were allocated to the norm group (NG). Participants completed measures that were related to latent variables derived from the Resilience Model for Breast Cancer (RM-BC) at baseline (T1), 2 months (T2), 6 months (T3), and 12 months (T4) after intervention. At T2, the IG reported significantly lower Depression (ES = 0.65,P = 0.0019) and Illness Uncertainty (ES = 0.57, P = 0.004), better Hope (ES = 0.81, P < 0.001) and QOL (ES = 0.60, P = 0.002) than did the CG. At T3, the IG reported significantly lower Anxiety (ES = 0.74, P < 0.001), better Social Support (ES = 0.51,P = 0.009), Transcendence (ES = 0.87, P < 0.001), and Resilience (ES = 0.83, P < 0.001) compared with the CG. At T4, the IG reported better Resilience though not significant (P = 0.085) and better Transcendence (P = 0.0243) than did the NG. The BRBC intervention improves the positive health outcomes and decreases the risk factors of illness-related distress of breast cancer patients during the high-risk cancer treatment.

摘要

为降低中国大陆乳腺癌患者出现适应问题的风险,我们考察了一项多学科导师指导项目——“乳腺癌康复力计划”(BRBC)的效果,该项目在乳腺癌手术后实施,旨在(a)增强社会支持、对未来的希望等保护因素;(b)降低身体和情绪困扰的风险因素;(c)提高康复力、超越感和生活质量(QOL)。在6家专科癌症医院开展了一项多中心随机对照试验。分别将101名和103名乳腺癌患者分配至干预组(IG)和对照组(CG),并将112名普通女性(无乳腺癌)分配至常模组(NG)。参与者在干预后的基线期(T1)、2个月(T2)、6个月(T3)和12个月(T4)完成了与源自乳腺癌康复力模型(RM-BC)的潜在变量相关的测量。在T2时,与CG相比,IG报告的抑郁水平显著更低(效应量ES = 0.65,P = 0.0019)、疾病不确定性显著更低(ES = 0.57,P = 0.004)、希望水平更高(ES = 0.81,P < 0.001)以及生活质量更高(ES = 0.60,P = 0.002)。在T3时,与CG相比,IG报告的焦虑水平显著更低(ES = 0.74,P < 0.001)、社会支持更好(ES = 0.51,P = 0.009)、超越感更好(ES = 0.87,P < 0.001)以及康复力更好(ES = 0.83,P < 0.001)。在T4时,与NG相比,IG报告的康复力虽不显著更好(P = 0.085),但超越感更好(P = 0.0243)。BRBC干预可改善乳腺癌患者在高风险癌症治疗期间的积极健康结果,并降低与疾病相关困扰的风险因素。

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