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行为睡眠干预的次要结果:一项随机临床试验。

Secondary outcomes of a behavioral sleep intervention: A randomized clinical trial.

机构信息

Department of Psychiatry and Behavioral Sciences.

Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center.

出版信息

Health Psychol. 2019 Mar;38(3):196-205. doi: 10.1037/hea0000700.

Abstract

OBJECTIVE

Nearly 80% of cancer patients struggle with insomnia, which is associated with decreased heart rate variability (HRV) and quality of life (QOL). The aim of this secondary analysis was to evaluate the possible effects of Brief Behavioral Therapy for Cancer-Related Insomnia (BBT-CI), delivered during chemotherapy visits, on QOL and HRV in patients with breast cancer (BC).

METHOD

QOL and HRV data were obtained during a pilot clinical trial assessing the feasibility and effects of BBT-CI on insomnia. A total of 71 BC patients (mean age = 52.5 years) were randomly assigned to either BBT-CI or a healthy-eating control intervention (HEAL). BBT-CI and HEAL were delivered over 6 weeks (2 face-to-face sessions plus 4 phone calls) by trained staff at 4 National Cancer Institute-funded Community Oncology Research Program clinics. QOL was measured with the Functional Assessment of Cancer Therapy (FACT-G) and HRV with the Firstbeat device at baseline and after intervention.

RESULTS

There were significant improvements in QOL after intervention for BBT-CI (FACT-G, p = .009; FACT-B, p = .016; ANCOVA) and 5-min supine HRV measures (SDNN, p = .005; rMSSD, p = .004; HF, p = .009; ANCOVA) compared with HEAL.

CONCLUSIONS

Patients randomized to BBT-CI showed improvements in QOL and HRV, providing support for BBT-CI's possible benefit when delivered in the community oncology setting by trained staff. A more definitive efficacy trial of BBT-CI is currently being planned with sufficient statistical power to evaluate the intervention's clinical utility. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

摘要

目的

近 80%的癌症患者存在失眠问题,这与心率变异性(HRV)降低和生活质量(QOL)下降有关。本二次分析旨在评估在化疗期间进行的简短行为治疗癌症相关失眠(BBT-CI)对乳腺癌(BC)患者 QOL 和 HRV 的可能影响。

方法

在一项评估 BBT-CI 对失眠的可行性和影响的试点临床试验中,获得了 QOL 和 HRV 数据。共有 71 名 BC 患者(平均年龄=52.5 岁)被随机分配至 BBT-CI 或健康饮食对照干预(HEAL)组。BBT-CI 和 HEAL 由经过培训的工作人员在 4 家美国国立癌症研究所资助的社区肿瘤研究计划诊所中进行,为期 6 周(2 次面对面会议加 4 次电话咨询)。在基线和干预后使用功能评估癌症治疗量表(FACT-G)和 Firstbeat 设备测量 QOL,使用 5 分钟仰卧 HRV 指标测量 HRV。

结果

与 HEAL 相比,BBT-CI 干预后 QOL 显著改善(FACT-G,p=0.009;FACT-B,p=0.016;ANCOVA)和 5 分钟仰卧 HRV 指标(SDNN,p=0.005;rMSSD,p=0.004;HF,p=0.009;ANCOVA)。

结论

随机分配至 BBT-CI 的患者 QOL 和 HRV 均得到改善,这为在社区肿瘤环境中由经过培训的工作人员进行 BBT-CI 治疗提供了支持。目前正在计划一项更具决定性的 BBT-CI 疗效试验,以评估该干预措施的临床效用。(PsycINFO 数据库记录(c)2019 APA,保留所有权利)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d51c/6892630/8616222ead21/nihms-1015526-f0001.jpg

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