Cincidda Clizia, Pizzoli Silvia Francesca Maria, Pravettoni Gabriella
Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Milan, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
JMIR Cancer. 2022 Jan 11;8(1):e29745. doi: 10.2196/29745.
Patients with cancer and survivors may experience the fear of cancer recurrence (FCR), a preoccupation with the progression or recurrence of cancer. During the spread of COVID-19 in 2019, patients and survivors experienced increased levels of FCR. Hence, there is a greater need to identify effective evidence-based treatments to help people cope with FCR. Remotely delivered interventions might provide a valuable means to address FCR in patients with cancer.
The aim of this study is to first discuss the available psychological interventions for FCR based on traditional cognitive behavioral therapies (CBTs) or contemporary CBTs, in particular, mindfulness and acceptance and commitment therapy, and then propose a possible approach based on the retrieved literature.
We searched key electronic databases to identify studies that evaluated the effect of psychological interventions such as CBT on FCR among patients with cancer and survivors.
Current evidence suggests that face-to-face psychological interventions for FCR are feasible, acceptable, and efficacious for managing FCR. However, there are no specific data on the interventions that are most effective when delivered remotely.
CBT interventions can be efficacious in managing FCR, especially at posttreatment, regardless of whether it is delivered face to face, on the web, or using a blended approach. To date, no study has simultaneously compared the effectiveness of face-to-face, web-based, and blended interventions. On the basis of the retrieved evidence, we propose the hypothetical program of an intervention for FCR based on both traditional CBT and contemporary CBT, named Change Of Recurrence, which aims to improve the management of FCR in patients with cancer and survivors.
癌症患者及其幸存者可能会经历癌症复发恐惧(FCR),即对癌症进展或复发的过度担忧。在2019年新冠疫情传播期间,患者及幸存者的FCR水平有所上升。因此,更有必要确定有效的循证治疗方法来帮助人们应对FCR。远程提供的干预措施可能是解决癌症患者FCR问题的一种有价值的方式。
本研究的目的首先是讨论基于传统认知行为疗法(CBT)或当代CBT(特别是正念、接纳与承诺疗法)针对FCR的可用心理干预措施,然后根据检索到的文献提出一种可能的方法。
我们检索了主要电子数据库,以确定评估诸如CBT等心理干预措施对癌症患者及幸存者FCR影响的研究。
目前的证据表明,针对FCR的面对面心理干预措施对于管理FCR是可行、可接受且有效的。然而,对于远程提供时最有效的干预措施尚无具体数据。
CBT干预措施在管理FCR方面可能是有效的,尤其是在治疗后,无论其是面对面提供、通过网络提供还是采用混合方式。迄今为止,尚无研究同时比较面对面、基于网络和混合干预措施的有效性。基于检索到的证据,我们提出了一个基于传统CBT和当代CBT的针对FCR的干预措施的假设方案,名为“复发改变”,旨在改善癌症患者及幸存者对FCR的管理。