National Research Centre for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark.
Center for Quality, Region of Southern Denmark, Middelfart, Denmark.
Psychooncology. 2018 Mar;27(3):922-928. doi: 10.1002/pon.4613. Epub 2018 Jan 26.
Patients and partners both cope individually and as a dyad with challenges related to a breast cancer diagnosis. The objective of this study was to evaluate the effect of a psychological attachment-oriented couple intervention for breast cancer patients and partners in the early treatment phase.
A randomised controlled trial including 198 recently diagnosed breast cancer patients and their partners. Couples were randomised to the Hand in Hand (HiH) intervention in addition to usual care or to usual care only. Self-report assessments were conducted for both patients and partners at baseline, postintervention (5 months), and follow-up (10 months), assessing cancer-related distress, symptoms of anxiety and depression, and dyadic adjustment. Patients' cancer-related distress was the primary outcome.
Cancer-related distress decreased over time in both patients and partners, but the intervention did not significantly affect this decrease at postintervention (P = .08) or follow-up (P = .71). A significant positive effect was found on dyadic adjustment at follow-up for both patients (P = .04) and partners (P = .02).
There was no significant effect of the HiH intervention cancer-related distress. The results suggest that most couples can cope with cancer-related distress in the context of usual care. However, the positive effect on dyadic adjustment implies that the HiH intervention benefitted both patients and partners. Future studies should investigate how to integrate a couple focus in usual cancer care to improve dyadic coping in the early treatment phase.
患者及其伴侣在个体层面和伴侣关系层面均需应对与乳腺癌诊断相关的各种挑战。本研究旨在评估针对乳腺癌患者及其伴侣的心理依附导向型夫妻干预在早期治疗阶段的效果。
这是一项随机对照试验,纳入了 198 例近期确诊的乳腺癌患者及其伴侣。将夫妻随机分配至接受 Hand in Hand(HiH)干预+常规护理或仅接受常规护理。在基线、干预后(5 个月)和随访(10 个月)时对患者及其伴侣进行自我报告评估,评估内容包括癌症相关困扰、焦虑和抑郁症状以及伴侣关系调整。患者的癌症相关困扰是主要结局。
患者及其伴侣的癌症相关困扰均随时间推移而降低,但干预在干预后(P=.08)和随访时(P=.71)均未显著影响这种降低。随访时患者(P=.04)和伴侣(P=.02)的伴侣关系调整均出现显著的正向影响。
HiH 干预对癌症相关困扰无显著效果。结果提示,在常规护理背景下,大多数伴侣可以应对癌症相关困扰。然而,对伴侣关系调整的正向影响表明,HiH 干预使患者及其伴侣均受益。未来的研究应探讨如何将夫妻关注纳入常规癌症护理,以改善早期治疗阶段的伴侣应对。