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支持性癌症护理中的身心医学与生活方式改变:一项针对癌症患者日间护理诊所项目的队列研究。

Mind-body medicine and lifestyle modification in supportive cancer care: A cohort study on a day care clinic program for cancer patients.

作者信息

Jeitler Michael, Jaspers Jessica, von Scheidt Christel, Koch Barbara, Michalsen Andreas, Steckhan Nico, Kessler Christian S

机构信息

Institute of Social Medicine, Epidemiology and Health Economics, Charité Medical University, Berlin, Germany.

Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany.

出版信息

Psychooncology. 2017 Dec;26(12):2127-2134. doi: 10.1002/pon.4433. Epub 2017 May 9.

Abstract

OBJECTIVE

We developed an integrative day care clinic program for cancer patients focusing on mind-body techniques and health-promoting lifestyle modification (7-hour once-per-week group sessions over 12 weeks).

METHODS

A cohort study design with a waiting group was implemented. Outcome parameters were assessed at the beginning, at the end of the active program, and at a 6-month follow-up. Patients waiting >4 and <12 weeks before treatment start were allocated to the waiting group and additionally assessed at the start of their day care program. Outcome measures included quality of life (FACT-G, FACT-B/C, WHO-5), fatigue (FACIT-F), depression/anxiety (HADS), and mood states (ASTS). A per protocol analysis using mixed linear models was performed.

RESULTS

One hundred patients were screened on-site for eligibility. Eighty-six cancer survivors (83% female; mean age 53.7 ± 9.7 years; 49% breast cancer) were included into the study. Sixty-two patients were allocated to the intervention group and 24 patients, to the waiting group (mean waiting time 5 ± 1 weeks). Sixty-six data sets were included in the final analysis. Significant improvements were observed in favor of the intervention group after 12 weeks compared with the waiting group at the end of the waiting period for quality of life, anxiety/depression, and fatigue. Results from the 6-month follow-up for the whole study population showed lasting improvement of quality of life.

CONCLUSIONS

The program can be considered as an effective means to improve quality of life, fatigue, and mental health of cancer patients. Moreover, it appears to have a sustainable effect, which has to be proved in randomized trials.

摘要

目的

我们为癌症患者制定了一项综合日间护理诊所计划,重点关注身心技巧和促进健康的生活方式改变(为期12周,每周一次,每次7小时的小组课程)。

方法

实施了一项带有等待组的队列研究设计。在活动计划开始时、结束时以及6个月随访时评估结果参数。在治疗开始前等待超过4周且少于12周的患者被分配到等待组,并在其日间护理计划开始时进行额外评估。结果测量包括生活质量(FACT-G、FACT-B/C、WHO-5)、疲劳(FACIT-F)、抑郁/焦虑(HADS)和情绪状态(ASTS)。使用混合线性模型进行了符合方案分析。

结果

100名患者在现场接受了资格筛查。86名癌症幸存者(83%为女性;平均年龄53.7±9.7岁;49%为乳腺癌)被纳入研究。62名患者被分配到干预组,24名患者被分配到等待组(平均等待时间5±1周)。最终分析纳入了66个数据集。与等待组在等待期结束时相比,干预组在12周后生活质量、焦虑/抑郁和疲劳方面有显著改善。整个研究人群6个月随访结果显示生活质量持续改善。

结论

该计划可被视为改善癌症患者生活质量、疲劳和心理健康的有效手段。此外,它似乎具有可持续的效果,这有待在随机试验中得到证实。

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