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健康教练和基于网络的方案对癌症幸存者身体活动、体重和压力管理的疗效:一项多中心随机对照试验。

Efficacy of health coaching and a web-based program on physical activity, weight, and distress management among cancer survivors: A multi-centered randomised controlled trial.

机构信息

Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea.

Department of Education, Seoul National University College of Education, Seoul, South Korea.

出版信息

Psychooncology. 2020 Jul;29(7):1105-1114. doi: 10.1002/pon.5394. Epub 2020 Apr 23.

Abstract

OBJECTIVES

To investigate the efficacy of health coaching and a web-based program on survivor physical activity (PA), weight, and distress management among stomach, colon, lung and breast cancer patients.

METHODS

This randomised, controlled, 1-year trial conducted in five hospitals recruited cancer survivors within 2 months of completing primary cancer treatment who had not met ≥1 of these behavioural goals: (i) conducting moderate PA for at least 150 minutes/week or strenuous exercise for over 75 minutes per week or, in the case of lung cancer patients, low or moderate intensity exercise for over 12.5 MET per week, (ii) maintaining normal weight, and (iii) attaining a score >72 in the Post Traumatic Growth Inventory (PTGI). Participants were randomly assigned to one of three groups: the control group, a web-only group, or a health coaching + web group. The primary endpoint was based on a composite of PA, weight, and PTGI score at 12 months.

RESULTS

Patients in the health coaching + web group (difference = 6.6%, P = .010) and the web-only group (difference = 5.9%, P = .031) had greater overall improvements across the three-outcome composite than the control group. The health coaching + web group had greater overall improvement in PTGI (difference = 12.6%; P < .001) than the control group, but not in PA and weight.

CONCLUSION

The web-based program, with or without health coaching, may improve health behaviours including PA, weight, and distress management among cancer survivors within 2 months of completing primary cancer treatment. The web-based program with health coaching was mainly effective for reducing psychological distress.

摘要

目的

调查健康指导和基于网络的方案对胃、结肠、肺和乳腺癌患者幸存者身体活动(PA)、体重和压力管理的效果。

方法

这项在五家医院进行的随机、对照、为期一年的试验招募了癌症幸存者,他们在完成主要癌症治疗后 2 个月内尚未达到以下行为目标中的 1 个:(i)每周进行至少 150 分钟中等强度 PA 或超过 75 分钟剧烈运动,或对于肺癌患者,每周进行超过 12.5 梅脱的低或中等强度运动,(ii)保持正常体重,和(iii)在创伤后成长量表(PTGI)中获得>72 分。参与者被随机分配到以下三组之一:对照组、仅网络组或健康指导+网络组。主要终点是基于 12 个月时 PA、体重和 PTGI 评分的综合结果。

结果

健康指导+网络组(差异=6.6%,P=0.010)和仅网络组(差异=5.9%,P=0.031)在三个结果综合指标上的总体改善大于对照组。健康指导+网络组在 PTGI 上的总体改善大于对照组(差异=12.6%;P<0.001),但在 PA 和体重方面没有差异。

结论

基于网络的方案,无论是否有健康指导,都可能在完成主要癌症治疗后 2 个月内改善癌症幸存者的健康行为,包括 PA、体重和压力管理。具有健康指导的基于网络的方案主要对减轻心理压力有效。

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