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意义中心团体心理治疗对癌症幸存者的长期疗效:一项随机对照试验的 2 年随访结果。

Long-term efficacy of meaning-centered group psychotherapy for cancer survivors: 2-Year follow-up results of a randomized controlled trial.

机构信息

Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute (APH), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute (APH), Amsterdam, The Netherlands.

出版信息

Psychooncology. 2020 Apr;29(4):711-718. doi: 10.1002/pon.5323. Epub 2020 Feb 6.

Abstract

OBJECTIVE

Meaning-centered group psychotherapy for cancer survivors (MCGP-CS) is an effective intervention to improve personal meaning, psychological well-being, and depressive symptoms until 6 months after the intervention. In this study, the long-term effects of MCGP-CS (i.e., at 1- and 2-year follow-up) on meaning, psychological well-being and posttraumatic growth were assessed, in comparison to supportive group psychotherapy (SGP) and care as usual (CAU).

METHODS

Cancer survivors (n = 170) were randomized into MCGP-CS, SGP, or CAU. Assessments were scheduled at baseline, 1 week, 3 months, 6 months, 1 year, and 2 years postintervention. Outcome measures were the Personal Meaning Profile, Ryff's Scales of Psychological Well-Being (SPWB), the Posttraumatic Growth Inventory, and their subscales. Linear mixed models (LMM) were used and results were both reported on an intention-to-treat (ITT) basis, as well as for intervention completers only.

RESULTS

LMM and post hoc analyses with Bonferroni correction revealed that MCGP-CS participants reported more improvement on positive relations (subscale of SPWB) than CAU participants of 2-year postintervention (ITT analysis, Cohen's d = .82). Completers also reported more personal growth (subscale of SPWB) after MCGP-CS than after SGP 1-year postintervention (Cohen's d = .94). No long-term effects were found on the other outcome measures.

CONCLUSIONS

In the 2 years after MCGP-CS, the short-term significant effects on personal meaning and most positive effects related to psychological well-being faded. However, MCGP-CS had a long-term positive effect on positive relations with others and on survivors' sense of personal growth.

TRIAL REGISTRATION

Netherlands Trial Register: NTR3571.

摘要

目的

以意义为中心的癌症幸存者团体心理治疗(MCGP-CS)是一种有效的干预措施,可提高个人意义、心理幸福感和抑郁症状,直到干预后 6 个月。在这项研究中,与支持性团体心理治疗(SGP)和常规护理(CAU)相比,评估了 MCGP-CS 的长期效果(即 1 年和 2 年随访时)对意义、心理幸福感和创伤后成长的影响。

方法

将癌症幸存者(n=170)随机分为 MCGP-CS、SGP 或 CAU 组。评估安排在基线、1 周、3 个月、6 个月、1 年和 2 年干预后。结局指标为个人意义档案、Ryff 的心理幸福感量表(SPWB)、创伤后成长量表及其子量表。采用线性混合模型(LMM)进行分析,结果基于意向治疗(ITT)和干预完成者进行报告。

结果

LMM 和事后 Bonferroni 校正的分析结果显示,与 CAU 组相比,2 年随访时 MCGP-CS 组的积极关系(SPWB 子量表)得分改善更为显著(ITT 分析,Cohen's d=0.82)。完成者还报告称,与 SGP 相比,1 年后 MCGP-CS 组的个人成长(SPWB 子量表)更多(Cohen's d=0.94)。在其他结局指标上未发现长期效果。

结论

在 MCGP-CS 后 2 年内,个人意义的短期显著效果和与心理幸福感最相关的积极效果逐渐消失。然而,MCGP-CS 对与他人的积极关系和幸存者的个人成长感产生了长期的积极影响。

试验注册

荷兰试验注册处:NTR3571。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c36d/7217171/5d16c4710d42/PON-29-711-g001.jpg

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