Schellekens M P J, van den Hurk D G M, Prins J B, Donders A R T, Molema J, Dekhuijzen R, van der Drift M A, Speckens A E M
Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
Department of Pulmonary Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands.
Psychooncology. 2017 Dec;26(12):2118-2126. doi: 10.1002/pon.4430. Epub 2017 Apr 26.
Lung cancer patients report among the highest distress rates of all cancer patients. Partners report similar distress rates. The present study examined the effectiveness of additional mindfulness-based stress reduction (care as usual [CAU] + MBSR) versus solely CAU to reduce psychological distress in lung cancer patients and/or their partners.
We performed a multicentre, parallel-group, randomized controlled trial. Mindfulness-based stress reduction is an 8-week group-based intervention, including mindfulness practice and teachings on stress. Care as usual included anticancer treatment, medical consultations, and supportive care. The primary outcome was psychological distress. Secondary outcomes included quality of life, caregiver burden, relationship satisfaction, mindfulness skills, self-compassion, rumination, and posttraumatic stress symptoms. Outcomes were assessed at baseline, post-intervention, and 3-month follow-up. Linear mixed modeling was conducted on an intention-to-treat sample. Moderation (gender, disease stage, baseline distress, participation with/without partner) and mediation analyses were performed.
A total of 31 patients and 21 partners were randomized to CAU + MBSR and 32 patients and 23 partners to CAU. After CAU + MBSR patients reported significantly less psychological distress (p = .008, d = .69) than after CAU. Baseline distress moderated outcome: those with more distress benefitted most from MBSR. Additionally, after CAU + MBSR patients showed more improvements in quality of life, mindfulness skills, self-compassion, and rumination than after CAU. In partners, no differences were found between groups.
Our findings suggest that psychological distress in lung cancer patients can be effectively treated with MBSR. No effect was found in partners, possibly because they were more focused on patients' well-being rather than their own.
肺癌患者的痛苦率在所有癌症患者中位居前列。其伴侣的痛苦率也与之相似。本研究旨在探讨在常规护理(CAU)基础上增加基于正念减压疗法(CAU + MBSR)与单纯CAU相比,对减轻肺癌患者及其伴侣心理痛苦的效果。
我们开展了一项多中心、平行组、随机对照试验。基于正念减压疗法是一项为期8周的团体干预,包括正念练习和压力相关教导。常规护理包括抗癌治疗、医疗咨询和支持性护理。主要结局是心理痛苦。次要结局包括生活质量、照顾者负担、关系满意度、正念技能、自我同情、沉思和创伤后应激症状。在基线、干预后和3个月随访时评估结局。对意向性治疗样本进行线性混合模型分析。进行了调节分析(性别、疾病分期、基线痛苦程度、是否有伴侣参与)和中介分析。
共有31例患者和21名伴侣被随机分配至CAU + MBSR组,32例患者和23名伴侣被随机分配至CAU组。与CAU后相比,CAU + MBSR组患者报告的心理痛苦显著减轻(p = 0.008,d = 0.69)。基线痛苦程度调节了结局:痛苦程度较高者从MBSR中获益最大。此外,与CAU后相比,CAU + MBSR组患者在生活质量、正念技能、自我同情和沉思方面的改善更大。在伴侣中,两组之间未发现差异。
我们的研究结果表明,MBSR可有效治疗肺癌患者的心理痛苦。在伴侣中未发现效果,可能是因为他们更关注患者的幸福而非自身。