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一项简短的心理教育干预可提高有认知问题的乳腺癌幸存者的记忆满意度:一项单臂前瞻性研究的结果。

A brief psychoeducational intervention improves memory contentment in breast cancer survivors with cognitive concerns: results of a single-arm prospective study.

机构信息

Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada.

Department of Psychiatry, University of Toronto, Toronto, Canada.

出版信息

Support Care Cancer. 2018 Aug;26(8):2851-2859. doi: 10.1007/s00520-018-4135-z. Epub 2018 Mar 10.

Abstract

PURPOSE

One in three breast cancer survivors experiences persistent cognitive changes that can negatively impact daily functioning and quality of life. In our cancer center, the largest tertiary cancer center in Canada, patients with self-reported cancer-related cognitive dysfunction (CRCD) are offered psychoeducation intended to reduce distress about CRCD symptoms and improve everyday cognitive performance, but evidence regarding this intervention's impact is lacking. Here, we assess whether a 1-hour (h), individual psychoeducational intervention designed to promote self-management of CRCD symptoms can improve attitudes and coping with memory-related difficulties in women with breast cancer.

METHODS

Breast cancer survivors with self-reported CRCD (N = 100) were assessed immediately before, immediately after, and 6 weeks following the intervention. Participants' memory contentment, knowledge of CRCD, symptom distress, and self-efficacy to cope with symptoms were measured.

RESULTS

Participants showed improvements in memory contentment immediately after the intervention (Cohen's d effect size and 95% CI = 0.87 [0.58, 1.16]) and 6 weeks later (d = 0.77 [0.48, 1.05]). Significant improvements in secondary study outcomes, including knowledge of CRCD (d = 1.32 [1.01, 1.63]), symptom distress (d = - 0.82 [- 1.11, - 0.53]), and self-efficacy to cope with cognitive symptoms (d = 1.45 [1.14, 1.76]), were also observed.

CONCLUSIONS

A single, 1-hour psychoeducational intervention can achieve lasting and improved adjustment to memory symptoms in breast cancer survivors with self-reported CRCD. Further investigation using a randomized controlled study design is warranted. Comparisons with previously reported psychoeducational interventions for CRCD are made, and next steps for this research are discussed.

摘要

目的

三分之一的乳腺癌幸存者经历持续的认知变化,这可能会对日常功能和生活质量产生负面影响。在我们的癌症中心,这是加拿大最大的三级癌症中心,有自我报告的与癌症相关的认知障碍 (CRCD) 的患者会接受心理教育,旨在减轻对 CRCD 症状的困扰,并改善日常认知表现,但缺乏关于这种干预措施效果的证据。在这里,我们评估了 1 小时(h)的个体心理教育干预措施,旨在促进对 CRCD 症状的自我管理,是否可以改善乳腺癌女性对记忆相关困难的态度和应对方式。

方法

有自我报告的 CRCD(N=100)的乳腺癌幸存者在干预前、干预后立即和 6 周后进行评估。参与者的记忆满意度、对 CRCD 的了解、症状困扰和应对症状的自我效能感都进行了测量。

结果

参与者在干预后立即表现出记忆满意度的提高(Cohen's d 效应大小和 95%CI=0.87 [0.58, 1.16]),并在 6 周后保持提高(d=0.77 [0.48, 1.05])。包括对 CRCD 的了解(d=1.32 [1.01, 1.63])、症状困扰(d=−0.82 [−1.11, −0.53])和应对认知症状的自我效能感(d=1.45 [1.14, 1.76])在内的次要研究结果也有显著改善。

结论

单次 1 小时的心理教育干预可以使自我报告的 CRCD 的乳腺癌幸存者对记忆症状产生持久和改善的调整。使用随机对照研究设计进行进一步调查是必要的。与之前报道的 CRCD 心理教育干预进行了比较,并讨论了该研究的下一步措施。

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