Mifsud Angela, Pehlivan Melissa J, Fam Paul, O'Grady Maddison, van Steensel Annamiek, Elder Elisabeth, Gilchrist Jenny, Sherman Kerry A
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia.
Health Psychol Behav Med. 2021 May 21;9(1):498-526. doi: 10.1080/21642850.2021.1929236.
The majority of breast cancer survivors (BCSs) experience body image concerns following treatment. Body Image distress (BID) is associated with psychological distress and diminished quality of life. A web-based self-compassion focused writing activity (My Changed Body - MyCB) reduces BID in BCSs, yet limited research exists on participant characteristics associated with such intervention adherence. Self-compassion-based meditations are also efficacious in reducing BID in non-BCS populations. This parallel, double-blind pilot randomised controlled trial aimed to assess the feasibility and acceptability of MyCB, with and without an additional meditation component, on BID and related psychological outcomes in BCSs. The trial was registered with the Australian and New Zealand Clinical Trials Registry (#ACTRN12619001693112).
BCSs were randomly allocated to MyCB ( = 39), MyCB + Meditation (MyCB + M) ( = 17) or an expressive writing (EW) active control arm ( = 23). The primary outcome was BID. Secondary outcomes were body appreciation, affect (positive and negative), psychological distress (depression, anxiety and stress) and self-compassion (state and trait). Assessments were completed online at baseline, post-intervention and 1-month.
Adherence to the MyCB writing (45%) and meditation (50%) was modest, and acceptability was high for both MyCB and MyCB + M. Intent to treat linear mixed model analyses indicated: Post-intervention - state self-compassion and positive affect increased for MyCB compared to EW; 1-month: BID scores decreased across all conditions; trait self-compassion increased and anxiety decreased for MyCB + M compared to MyCB and EW.
These findings provide preliminary evidence for the efficacy and potential clinical use of the MyCB brief web-based self-compassion intervention alone and with the addition of meditation, to increase self-compassion and psychological wellbeing in BCSs.
大多数乳腺癌幸存者在接受治疗后会出现身体形象方面的困扰。身体形象困扰(BID)与心理困扰和生活质量下降有关。一项基于网络的以自我同情为重点的写作活动(“我的改变的身体 - MyCB”)可减轻乳腺癌幸存者的身体形象困扰,但关于与这种干预依从性相关的参与者特征的研究有限。基于自我同情的冥想在减轻非乳腺癌幸存者群体的身体形象困扰方面也很有效。这项平行、双盲的试点随机对照试验旨在评估MyCB(有或没有额外的冥想成分)对乳腺癌幸存者的身体形象困扰及相关心理结果的可行性和可接受性。该试验已在澳大利亚和新西兰临床试验注册中心注册(#ACTRN12619001693112)。
乳腺癌幸存者被随机分配到MyCB组(n = 39)、MyCB + 冥想组(MyCB + M,n = 17)或表达性写作(EW)活性对照组(n = 23)。主要结局是身体形象困扰。次要结局包括身体欣赏、情感(积极和消极)、心理困扰(抑郁、焦虑和压力)以及自我同情(状态和特质)。在基线、干预后和1个月时通过在线方式完成评估。
MyCB写作的依从性(45%)和冥想的依从性(50%)一般,MyCB和MyCB + M的可接受性都很高。意向性分析线性混合模型分析表明:干预后 - 与EW相比,MyCB组的状态自我同情和积极情感增加;1个月时 - 所有组的身体形象困扰得分均下降;与MyCB和EW相比,MyCB + M组的特质自我同情增加,焦虑减少。
这些发现为单独使用MyCB简短的基于网络的自我同情干预以及添加冥想以增加乳腺癌幸存者的自我同情和心理健康的疗效和潜在临床应用提供了初步证据。