Department of Psychology and Neuroscience.
Rocky Mountain Cancer Centers.
J Consult Clin Psychol. 2021 Apr;89(4):327-340. doi: 10.1037/ccp0000630.
Anxiety symptoms are common among cancer survivors. This study evaluated whether an acceptance-based group intervention delivered by social workers in community oncology clinics improved anxiety and related symptoms, and healthcare use, relative to enhanced usual care (EUC).
This multi-site trial included 135 survivors of various cancers with moderate to high anxiety about cancer/survivorship, 1.5-24 months after treatment. Participants were randomized 1:1 to a 7-session acceptance and commitment therapy (ACT)-based group (Valued Living) or EUC (access to onsite supportive care plus resource list). Questionnaires were administered at baseline, 1, 2, 5, and 8 months post-randomization, diagnostic interviews at baseline, 2, and 8 months, and healthcare use tracked throughout. Outcomes included anxiety symptoms (primary), related symptoms, and healthcare use. Putative moderators included age, anxiety, and avoidance.
In intent-to-treat comparisons to EUC, Valued Living (VL) showed a nonsignificant pattern of greater improvement on anxiety symptoms (p = .08), improved significantly more on cancer-related post-traumatic stress (p = .002), fear of recurrence (p = .003), and energy/fatigue (p = .02), and missed significantly fewer medical appointments (p < .05). Conditions improved similarly on depressive symptoms, sense of meaning, and most severe anxiety or depressive disorder. Effects were moderated: VL participants with higher baseline anxiety or avoidance (+1SD) improved more on anxiety, meaning (p ≤ .01), and disorder severity (p = .05) than their EUC counterparts.
An acceptance-based group intervention delivered in community oncology clinics enhanced psychological recovery and energy levels, and reduced missed medical appointments for anxious cancer survivors, with stronger effects for more distressed participants. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
焦虑症状在癌症幸存者中很常见。本研究评估了在社区肿瘤诊所由社会工作者提供的基于接纳的小组干预是否比增强的常规护理（EUC）更能改善焦虑及相关症状和医疗保健的使用。
这项多站点试验纳入了 135 名患有各种癌症的幸存者，他们在治疗后 1.5-24 个月对癌症/生存感到中度或高度焦虑。参与者按 1:1 随机分为接受和承诺疗法（ACT）为基础的小组（有价值的生活）或 EUC（获得现场支持性护理和资源清单）。在基线、1、2、5 和 8 个月时进行问卷调查，在基线、2 和 8 个月时进行诊断访谈，并跟踪整个医疗保健的使用情况。结果包括焦虑症状（主要结果）、相关症状和医疗保健的使用。潜在的调节因素包括年龄、焦虑和回避。
与 EUC 相比，在意向治疗比较中，有价值的生活（VL）显示出焦虑症状改善的非显著性模式（p=0.08），癌症相关创伤后应激（p=0.002）、复发恐惧（p=0.003）和精力/疲劳（p=0.02）的改善显著，错过的医疗预约明显减少（p<0.05）。条件在抑郁症状、意义感和最严重的焦虑或抑郁障碍上也有类似的改善。这些效果是可以调节的：VL 组中基线时焦虑或回避较高（+1SD）的参与者在焦虑、意义（p≤0.01）和障碍严重程度（p=0.05）方面的改善比他们的 EUC 对照组更多。
在社区肿瘤诊所提供的基于接纳的小组干预增强了焦虑癌症幸存者的心理康复和精力水平，并减少了他们错过的医疗预约，对更痛苦的参与者效果更强。
