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采用随机对照试验比较身心整合干预与认知行为疗法在肺癌患者医患平行组中的疗效。

Comparing the efficacy of integrative body-mind-spirit intervention with cognitive behavioral therapy in patient-caregiver parallel groups for lung cancer patients using a randomized controlled trial.

机构信息

Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong.

Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong.

出版信息

J Psychosoc Oncol. 2020 Jul-Aug;38(4):389-405. doi: 10.1080/07347332.2020.1722981. Epub 2020 Mar 9.

Abstract

This paper reports the comparative efficacies of integrative body-mind-spirit intervention (I-BMS) and cognitive behavioral therapy (CBT) in patient-caregiver parallel groups for Chinese patients with lung cancer. Randomized controlled trial (RCT). One hundred and fifty-seven patient-caregiver dyads with no marked functional impairment were randomized into one of the two interventions with eight weekly patient-caregiver parallel groups. Assessments were conducted at baseline, within one, eight- and sixteen-weeks post-intervention. Effects of treatment group across time were analyzed by multilevel modeling. CBT led to greater reduction in emotional vulnerability than I-BMS. I-BMS resulted in greater increase in overall QoL and spiritual self-care, and more reduction in depression than CBT. Patients in both interventions experienced improvement in physical, emotional and spiritual, except social, domains of QoL. I-BMS was more efficacious for diverse domains of QoL, and CBT was more effective for emotional well-being, despite the relatively small between-group effect sizes. (1) With the expanding repertoire of psychosocial interventions for families facing lung cancer, it has become imperative to investigate the comparative efficacies of empirically supported and culturally adapted interventions. (2) Our findings show that I-BMS was more effective for diverse domains of QoL, while CBT was more efficacious with emotional well-being, although both interventions led to significant improvements in physical, emotional and spiritual domains of patient QoL. (3) Patient-caregiver parallel groups have been shown to be effective for enhancing QoL of Chinese lung cancer patients. (4) Care professionals are encouraged to dispense interventions based on the idiosyncratic needs and preferences of the patients to maximize the treatment effects.

摘要

本文报告了身心整合干预(I-BMS)和认知行为疗法(CBT)在并行的患者-照顾者组中对中国肺癌患者的疗效比较。随机对照试验(RCT)。将 157 对无明显功能障碍的患者-照顾者随机分为两组干预组之一,每组有 8 个平行的患者-照顾者组。在基线、干预后 1、8 和 16 周进行评估。通过多层次模型分析治疗组随时间的变化。CBT 导致情绪脆弱性降低的效果优于 I-BMS。I-BMS 导致整体 QoL 和精神自我保健增加,抑郁减少的效果优于 CBT。两组患者在除社会领域外的身体、情感和精神领域的 QoL 均有所改善。I-BMS 在多个 QoL 领域更有效,CBT 在情绪健康方面更有效,尽管组间效果大小相对较小。(1)随着针对面临肺癌的家庭的心理社会干预措施的不断扩展,有必要研究经过实证支持和文化适应的干预措施的比较疗效。(2)我们的研究结果表明,I-BMS 对 QoL 的多个领域更有效,而 CBT 对情绪健康更有效,尽管两种干预都显著改善了患者身体、情感和精神方面的 QoL。(3)患者-照顾者平行组已被证明能有效提高中国肺癌患者的生活质量。(4)鼓励护理专业人员根据患者的特殊需求和偏好提供干预措施,以最大限度地提高治疗效果。

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