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基于接纳与承诺疗法和自我同情训练的癌症患者伴侣网络自助干预:自动化反馈与个性化反馈的随机对照试验。

Web-based self-help intervention for partners of cancer patients based on acceptance and commitment therapy and self-compassion training: a randomized controlled trial with automated versus personal feedback.

机构信息

Department of Psychology, Health & Technology, Centre for eHealth & Well-being Research, University of Twente, P.O. Box 217, 7500, AE, Enschede, The Netherlands.

Roessingh Research & Development, P.O. Box 310, 7500, AH, Enschede, The Netherlands.

出版信息

Support Care Cancer. 2021 Sep;29(9):5115-5125. doi: 10.1007/s00520-021-06051-w. Epub 2021 Feb 19.

Abstract

PURPOSE

To evaluate the effectiveness of two versions (personal or automated feedback) of a psychological Web-based self-help intervention targeting partners of cancer patients. The intervention was based on acceptance and commitment therapy (ACT) and self-compassion training. Participants' adherence and their satisfaction were also studied.

METHODS

Two hundred three partners of patients with heterogeneous entities of cancer were randomized into three conditions: personal feedback (PF) (n = 67), automated feedback (AF) (n = 70), or waiting list (WL) control (n = 66). Participants completed measures at baseline (T0) and post-intervention (T1; 3 months after baseline) to assess psychological distress (HADS; primary outcome), positive mental health, caregiver strain, general health (secondary outcomes), posttraumatic growth, resilience, self-compassion, psychological flexibility, sense of mastery, and relational communication style (process measures). Participants in the two experimental conditions also completed these measures at follow-up (T2; 6 months after baseline).

RESULTS

There was no significant difference in change in psychological distress, positive mental health, caregiver strain and general health from T0 to T1 for either of the experimental conditions compared with the WL-condition. However, when compared to a WL-condition, the PF-condition was effective in increasing psychological flexibility (effect size d = 0.49) and resilience (d = 0.12) and decreasing overprotection (d = 0.25), and the AF-condition was effective in reducing overprotection (d = 0.36) and improving protective buffering (d = 0.36). At follow-up, the PF-condition was more effective than the AF-condition for improving mental health (d = 0.36), psychological flexibility (d = 0.60), mastery (d = 0.48), and protective buffering (d = 0.24). Participants positively appreciated the intervention and 69% participants were adherent.

CONCLUSION

This study demonstrates that a Web-based intervention based on ACT and self-compassion training with automated or personal feedback does not seem to improve psychological distress; however, it may have the potential to support partners of cancer patients to cope with the difficult situation they are facing. The condition with personal feedback seemed to be more beneficial.

摘要

目的

评估两种版本(个人或自动反馈)的针对癌症患者伴侣的基于心理学的网络自助干预的有效性。该干预基于接受和承诺疗法(ACT)和自我同情训练。还研究了参与者的依从性和满意度。

方法

203 名癌症患者的伴侣被随机分为三组:个人反馈(PF)组(n = 67)、自动反馈(AF)组(n = 70)或等候名单(WL)对照组(n = 66)。参与者在基线(T0)和干预后(T1;基线后 3 个月)完成测量,以评估心理困扰(HADS;主要结果)、积极的心理健康、照顾者负担、一般健康(次要结果)、创伤后成长、韧性、自我同情、心理灵活性、掌握感和关系沟通风格(过程测量)。两个实验组的参与者还在随访(T2;基线后 6 个月)时完成了这些测量。

结果

与 WL 条件相比,两个实验组在 T0 到 T1 期间,心理困扰、积极心理健康、照顾者负担和一般健康状况均无显著变化。然而,与 WL 条件相比,PF 条件在增加心理灵活性(效应大小 d = 0.49)和韧性(d = 0.12)和减少过度保护(d = 0.25)方面有效,而 AF 条件在降低过度保护(d = 0.36)和改善保护缓冲(d = 0.36)方面有效。在随访时,PF 组在改善心理健康(d = 0.36)、心理灵活性(d = 0.60)、掌握感(d = 0.48)和保护缓冲(d = 0.24)方面比 AF 组更有效。参与者对干预措施给予了积极评价,69%的参与者依从性良好。

结论

本研究表明,基于 ACT 和自我同情训练的网络干预,无论是提供个人反馈还是自动反馈,似乎都不能改善心理困扰;然而,它可能有潜力支持癌症患者的伴侣应对他们所面临的困难局面。提供个人反馈的条件似乎更有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7017/8295082/29790de5a277/520_2021_6051_Fig1_HTML.jpg

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