Park Sunre, Sado Mitsuhiro, Fujisawa Daisuke, Sato Yasuko, Takeuchi Mari, Ninomiya Akira, Takahashi Maiko, Yoshimura Kimio, Jinno Hiromitsu, Takeda Yuko
Faculty of Nursing and Medicine Care, Keio University.
Palliative Care Center, Keio University Hospital.
Jpn J Clin Oncol. 2018 Jan 1;48(1):68-74. doi: 10.1093/jjco/hyx156.
Mindfulness-based intervention has been receiving growing attention in cancer care. This study aimed to examine feasibility and to preliminary explore effectiveness of mindfulness-based cognitive therapy (MBCT) in Japanese breast cancer patients, and to explore possible modification of the program so that it fits better with this population.
Twelve participants with diagnosis of Stage I-III breast cancer received an eight session, weekly MBCT intervention in a group therapy format. The participants were followed up until 3 months after the completion of the program.
All the participants completed the program with high attendance rate (mean number of attended sessions = 7.7). Significant improvement in anxiety (Hospital Anxiety and Depression Scale (HADS) - anxiety subscale; effect size Cohen's d = 0.88, P < 0.05), trauma-related psychological symptoms (Impact of Event Scale-revised; d = 0.64, P < 0.01) and quality of life (Functional Assessment of Cancer Therapy-Breast Cancer: FACT-B; d = 0.72, P < 0.01), and trend-level improvement in depression (HADS - depression subscale; d = 0.53, P = 0.054) were observed. Qualitative analyses suggested the program may be beneficial for alleviating fear of cancer recurrence and for increasing spiritual well-being. Some recommended modification of the program was indicated from the post-intervention interviews.
Mindfulness-based cognitive therapy was well accepted by Japanese breast cancer patients and yielded favorable effect on their psychological status and quality of life. Further effectiveness study in a randomized-control design is warranted.
基于正念的干预措施在癌症护理中受到越来越多的关注。本研究旨在检验基于正念的认知疗法（MBCT）在日本乳腺癌患者中的可行性，并初步探索其有效性，同时探索对该方案进行可能的调整，使其更适合这一人群。
12名诊断为I - III期乳腺癌的参与者以团体治疗的形式接受了为期8周、每周一次的MBCT干预。对参与者进行随访，直至该方案完成后3个月。
所有参与者均以高出席率完成了该方案（平均出席课程数 = 7.7）。焦虑（医院焦虑抑郁量表（HADS）-焦虑分量表；效应量Cohen's d = 0.88，P < 0.05）、创伤相关心理症状（事件影响量表修订版；d = 0.64，P < 0.01）和生活质量（癌症治疗功能评估-乳腺癌：FACT - B；d = 0.72，P < 0.01）有显著改善，抑郁（HADS - 抑郁分量表；d = 0.53，P = 0.054）有趋势性改善。定性分析表明，该方案可能有助于减轻对癌症复发的恐惧并提高精神幸福感。干预后访谈提出了一些对该方案的推荐调整。
基于正念的认知疗法被日本乳腺癌患者很好地接受，并对其心理状态和生活质量产生了良好效果。有必要在随机对照设计中进行进一步的有效性研究。
