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基于认知行为疗法的在线自助训练对降低癌症复发恐惧无作用:CAREST 多中心随机对照试验的初步结果。

No effect of CBT-based online self-help training to reduce fear of cancer recurrence: First results of the CAREST multicenter randomized controlled trial.

机构信息

Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands.

Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands.

出版信息

Psychooncology. 2020 Jan;29(1):86-97. doi: 10.1002/pon.5233. Epub 2019 Nov 13.

Abstract

OBJECTIVE

Fear of cancer recurrence (FCR) is a common consequence of surviving cancer; therefore, easily accessible self-help training could help many cancer survivors deal with FCR at low costs. The CAncer REcurrence Self-help Training (CAREST) trial evaluates the effectiveness of an online-tailored self-help training on the basis of evidence-based cognitive behavioral therapy principles in breast cancer survivors. Also, possible predictors for benefitting from the online self-help training were examined.

METHODS

This multicenter randomized controlled trial included 262 female breast cancer survivors, randomly assigned to either online self-help training (n = 130) or care as usual (CAU; n = 132). Participants completed questionnaires at baseline (T0), 3 months (T1; after intervention), and 9 months (T2). The primary outcome was FCR (Fear of Cancer Recurrence Inventory Severity subscale). Both effectiveness and predictors were analyzed with latent growth curve modeling (LGCM) according to the intention-to-treat principle.

RESULTS

LGCM showed no differences between the average latent slope in both groups (χ  = .23, P = .63), suggesting that the treatments did not differ in their change in FCR over time. Moreover, no differences were found in the effects of the predictors on the latent slope in both groups (χ  = .12, P = .73), suggesting that no significant predictors were found for the effect of the intervention on FCR.

CONCLUSION

There was no effect of the CBT-based online self-help training "Less fear after cancer" in the current study. Therefore, we recommend adding professional support to online interventions for FCR.

摘要

目的

癌症复发恐惧(FCR)是癌症幸存者的常见后果;因此,易于获得的自助培训可以帮助许多癌症幸存者以低成本应对 FCR。CAncer REcurrence Self-help Training(CAREST)试验基于基于循证认知行为疗法原则的在线量身定制自助培训,评估了其对乳腺癌幸存者的有效性。此外,还检查了从在线自助培训中受益的可能预测因素。

方法

这项多中心随机对照试验纳入了 262 名女性乳腺癌幸存者,随机分配至在线自助培训组(n=130)或常规护理组(CAU;n=132)。参与者在基线(T0)、3 个月(T1;干预后)和 9 个月(T2)时完成问卷。主要结局指标是 FCR(癌症复发恐惧量表严重程度子量表)。根据意向治疗原则,使用潜在增长曲线模型(LGCM)分析有效性和预测因素。

结果

LGCM 显示两组的平均潜在斜率之间没有差异(χ²=0.23,P=0.63),表明治疗组在 FCR 随时间的变化方面没有差异。此外,两组中预测因素对潜在斜率的影响均无差异(χ²=0.12,P=0.73),表明未发现对干预对 FCR 的影响有显著预测因素。

结论

在本研究中,基于 CBT 的在线自助培训“癌症后少恐惧”没有效果。因此,我们建议为 FCR 的在线干预添加专业支持。

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