治疗师辅助的基于网络的癌症丧亲后持续性悲伤障碍干预：随机对照试验
Therapist-Assisted Web-Based Intervention for Prolonged Grief Disorder After Cancer Bereavement: Randomized Controlled Trial.
作者信息
Kaiser Julia, Nagl Michaela, Hoffmann Rahel, Linde Katja, Kersting Anette
机构信息
Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany.
出版信息
JMIR Ment Health. 2022 Feb 8;9(2):e27642. doi: 10.2196/27642.
BACKGROUND
Bereavement due to cancer increases the risk of prolonged grief disorder. However, specialized treatment options for prolonged grief after a loss due to illness are still scarce.
OBJECTIVE
The aim of this study is to extend previous findings by evaluating a web-based cognitive behavioral intervention with asynchronous therapist support, consisting of structured writing tasks adapted specifically for prolonged grief after cancer bereavement.
METHODS
The intervention was evaluated in a purely web-based randomized waitlist-controlled trial. Open-access recruitment of participants was conducted on the web. Prolonged grief (Inventory of Complicated Grief), depression, anxiety, posttraumatic stress, posttraumatic growth, somatization, sleep quality, and mental and physical health were assessed on the web via validated self-report measures.
RESULTS
A total of 87 participants were randomized into the intervention group (IG; 44/87, 51%) or the waitlist control group (43/87, 49%). Of the participants, 7% (6/87) dropped out of the study (5/44, 11%, in the IG). Of the 39 completers in the IG, 37 (95%) completed all intervention tasks. The intervention reduced symptoms of prolonged grief (intention-to-treat: P<.001; η=0.34; Cohen d=0.80) to a clinically significant extent. It had favorable effects on depression, anxiety, posttraumatic stress, posttraumatic growth, and overall mental health but not on somatization, sleep quality, or physical health.
CONCLUSIONS
The web-based intervention for prolonged grief after cancer bereavement is effective in reducing symptoms of prolonged grief disorder and accompanying syndromes in a timely, easily realizable manner and addresses specific challenges of bereavement to illness. Considering web-based approaches in future mental health care policy and practice can reduce health care gaps for those who are bereaved to cancer.
TRIAL REGISTRATION
German Clinical Trial Register U1111-1186-6255; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011001.
背景
因癌症导致的丧亲之痛会增加长期悲伤障碍的风险。然而，针对因病失去亲人后长期悲伤的专门治疗方案仍然稀缺。
目的
本研究的目的是通过评估一种基于网络的认知行为干预措施来扩展先前的研究结果，该干预措施由专门为癌症丧亲后长期悲伤设计的结构化写作任务组成，并提供异步治疗师支持。
方法
在一项完全基于网络的随机等待列表对照试验中对该干预措施进行评估。通过网络进行公开招募参与者。通过经过验证的自我报告测量工具在网络上评估长期悲伤（复杂悲伤量表）、抑郁、焦虑、创伤后应激、创伤后成长、躯体化、睡眠质量以及心理和身体健康状况。
结果
共有87名参与者被随机分为干预组（IG；44/87，51%）或等待列表对照组（43/87，49%）。参与者中，7%（6/87）退出了研究（干预组中为5/44，11%）。在干预组的39名完成者中，37名（95%）完成了所有干预任务。该干预措施在临床上显著减轻了长期悲伤症状（意向性分析：P<.001；η=0.34；Cohen d=0.80）。它对抑郁、焦虑、创伤后应激、创伤后成长和整体心理健康有积极影响，但对躯体化、睡眠质量或身体健康没有影响。
结论
基于网络的癌症丧亲后长期悲伤干预措施能及时、轻松地减轻长期悲伤障碍症状及伴随综合征，并应对因病丧亲的特定挑战。在未来的心理健康护理政策和实践中考虑基于网络的方法可以缩小癌症丧亲者的医疗保健差距。
试验注册
德国临床试验注册中心U1111-1186-6255；https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011001 。
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