Børøsund Elin, Ehlers Shawna L, Clark Matthew M, Andrykowski Michael A, Cvancarova Småstuen Milada, Solberg Nes Lise
Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.
Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, Minnesota.
Cancer. 2022 Apr 1;128(7):1503-1512. doi: 10.1002/cncr.34046. Epub 2021 Dec 2.
Cognitive-behavioral stress management interventions are associated with improved psychological well-being for cancer survivors. The availability of, access to, and outreach of these in-person interventions are limited, however. The current study, therefore, evaluated the efficacy of StressProffen, a digital application (app)-based stress management intervention for cancer survivors, in a 12-month randomized controlled trial.
Cancer survivors 1 year or less after their treatment (N = 172) were randomized to the StressProffen intervention (n = 84) or a usual-care control group (n = 88). The intervention was delivered in a simple blended care model: 1) 1 in-person introduction session, 2) 10 app-based cognitive-behavioral stress management modules, and 3) 2 follow-up phone calls. Stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety and Depression Scale), self-regulatory fatigue (Self-Regulatory Fatigue 18), and health-related quality of life (HRQOL; RAND-36) were examined at the baseline and at 6 and 12 months. Generalized linear models for repeated measures were fitted to compare effects over time.
Participants were mainly female (82%), had a mean age of 52 years (standard deviation, 11.3 years; range, 20-78 years), and had a variety of cancer types (mostly breast cancer [48%]). Over the 12-month study time, the intervention group reported significantly decreased stress (P < .001), depression (P = .003), and self-regulatory fatigue (P = .002) as well as improved HRQOL (for 6 of 8 domains, P ≤ .015) in comparison with controls. The largest favored effects for the intervention group were observed at 6 months: stress (estimated mean difference [MD], -5.1; P < .001), anxiety (MD, -1.4; P = .015), depression (MD, -2.1; P < .001), self-regulatory fatigue (MD, -4.9; P < .001), and HRQOL (7 of 8 domains; P ≤ .037).
Digital stress management interventions such as StressProffen have the potential to extend the outreach of psychological interventions and provide easily available and effective psychosocial support for cancer survivors.
认知行为压力管理干预措施与癌症幸存者心理健康状况的改善相关。然而，这些面对面干预措施的可获得性、可及性和推广范围有限。因此，在一项为期12个月的随机对照试验中，本研究评估了StressProffen（一种基于数字应用程序（app）的癌症幸存者压力管理干预措施）的疗效。
治疗后1年及以内的癌症幸存者（N = 172）被随机分为StressProffen干预组（n = 84）或常规护理对照组（n = 88）。干预采用简单的混合护理模式：1）1次面对面介绍课程，2）10个基于app的认知行为压力管理模块，3）2次随访电话。在基线、6个月和12个月时检查压力（感知压力量表）、焦虑和抑郁（医院焦虑抑郁量表）、自我调节疲劳（自我调节疲劳18）以及健康相关生活质量（HRQOL；兰德36项健康调查量表）。采用重复测量的广义线性模型来比较不同时间的效果。
参与者主要为女性（82%），平均年龄52岁（标准差11.3岁；范围20 - 78岁），患有多种癌症类型（主要是乳腺癌[48%]）。在为期12个月的研究期间，与对照组相比，干预组报告压力（P < .001）、抑郁（P = .003）和自我调节疲劳（P = .002）显著降低，HRQOL也有所改善（8个领域中的6个，P ≤ .015）。干预组在6个月时观察到最大的有利效果：压力（估计平均差[MD]，-5.1；P < .001）、焦虑（MD，-1.4；P = .015）、抑郁（MD，-2.1；P < .001）、自我调节疲劳（MD，-4.9；P < .001）以及HRQOL（8个领域中的7个；P ≤ .037）。
诸如StressProffen之类的数字压力管理干预措施有可能扩大心理干预的推广范围，并为癌症幸存者提供便捷且有效的社会心理支持。
