Carlson Linda E, Rouleau Codie R, Speca Michael, Robinson John, Bultz Barry D
Department of Oncology, Cumming School of Medicine, University of Calgary, 1331 29St NW, Calgary, T2N 4N2, Alberta, Canada.
Division of Psychosocial Oncology, Tom Baker Cancer Centre, Cancer Control Alberta, Holy Cross Site 2202 2nd St SW, Calgary, T2S 3C1, Alberta, Canada.
Support Care Cancer. 2017 Apr;25(4):1035-1041. doi: 10.1007/s00520-016-3551-1. Epub 2017 Jan 7.
The purpose of this paper is to report the results of a negative randomized controlled trial, which piloted brief supportive-expressive therapy (SET) for partners of men with prostate cancer, and to discuss lessons learned for future clinical trials.
Partners of men with newly diagnosed, non-metastatic prostate cancer were randomized to SET (n = 45) or usual care (n = 32). SET involved six weekly group sessions emphasizing emotional expression, social support, and finding meaning in the cancer experience. Measures of mood disturbance, marital satisfaction, and social support were administered to both partners and patients at baseline, post-program, and at 3- and 6-month follow-up.
There were no significant differences between SET and the control group for either patients or their wives on any outcome. Regardless of group membership, partners reported improvements in total mood disturbance (p = .011), tension (p < .001), anger (p = .041), confusion (p < .001), state anxiety (p = .001), and emotional support (p = .037), and patients reported improvements in tension (p = .003), emotional support (p = .047), positive interaction support (p = .004), and overall social support (p = .026).
Compared to the natural course of recovery, SET did not improve psychosocial outcomes for either men with prostate cancer or their wives. Methodological challenges experienced in implementing this trial yield valuable lessons for future research, including designing interventions relevant to unique problems faced by specific groups, being closely guided by previous research, and the potential utility of screening for distress as an inclusion criteria in intervention trials.
本文旨在报告一项阴性随机对照试验的结果，该试验对前列腺癌患者的伴侣进行了简短的支持性表达疗法（SET）试点，并讨论从该试验中吸取的经验教训，为未来的临床试验提供参考。
将新诊断为非转移性前列腺癌患者的伴侣随机分为接受SET组（n = 45）或常规护理组（n = 32）。SET包括为期六周的小组会议，重点是情感表达、社会支持以及在癌症经历中寻找意义。在基线、项目结束后以及3个月和6个月随访时，对伴侣和患者进行情绪障碍、婚姻满意度和社会支持的测量。
在任何结果方面，SET组和对照组的患者及其妻子之间均无显著差异。无论所属组别如何，伴侣们报告在总体情绪障碍（p = 0.011）、紧张情绪（p < 0.001）、愤怒情绪（p = 0.041）、困惑情绪（p < 0.001）、状态焦虑（p = 0.001）和情感支持（p = 0.037）方面有所改善，患者报告在紧张情绪（p = 0.003）、情感支持（p = 0.047）、积极互动支持（p = 0.004）和总体社会支持（p = 0.026）方面有所改善。
与自然恢复过程相比，SET并未改善前列腺癌男性患者及其妻子的心理社会结局。实施该试验过程中遇到的方法学挑战为未来研究提供了宝贵经验，包括设计与特定群体所面临的独特问题相关的干预措施、紧密遵循先前的研究，以及在干预试验中将筛查痛苦作为纳入标准的潜在效用。
