Peter Gilgan Centre for Women's Cancers, Women's College Hospital, ON, Toronto, Canada.
Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
Support Care Cancer. 2022 Sep;30(9):7323-7332. doi: 10.1007/s00520-022-07148-6. Epub 2022 May 24.
Depression, anxiety, and fear of recurrence (FOR) are prevalent among cancer survivors, and it is recommended that they have access to supportive services and resources to address psychosocial needs during follow-up care. This study examined the impact of a virtual cognitive behavioral therapy (CBT)-based telephone coaching program (BounceBack®) on depression, anxiety, and FOR.
Through the After Cancer Treatment Transition (ACTT) clinic at the Women's College Hospital (Toronto, Canada), eligible participants were identified, consented, and referred to the BounceBack® program. Program participation involved completion of self-selected online workbooks and support from trained telephone coaches. Measures of depression (PHQ-9), anxiety (GAD-7), and FOR (fear of cancer recurrence inventory, FCRI) were collected at pre-intervention (baseline) and post-intervention (6-month and 12-month time points). For each psychosocial measure, paired t-tests compared mean scores between study time points. Participant experiences and perceptions were collected through a survey.
Measures of depression and anxiety significantly improved among participants from pre-intervention to post-intervention. Scores for PHQ-9 and GAD-7 decreased from moderate to mild levels. Measure of FOR also significantly improved, while FCRI sub-scale scores significantly improved for 5 of the 7 factors that characterize FOR (triggers, severity, psychological distress, functional impairment, insight). Participants rated the intervention a mean score of 7 (out of 10), indicating a moderate level of satisfaction and usefulness.
This study suggested that a virtual CBT-based telephone coaching program can be an effective approach to managing depression, anxiety, and fear of recurrence in cancer survivors.
抑郁症、焦虑症和复发恐惧（FOR）在癌症幸存者中普遍存在，建议他们在随访期间获得支持性服务和资源，以满足其心理社会需求。本研究探讨了虚拟基于认知行为疗法（CBT）的电话辅导计划（BounceBack®）对抑郁症、焦虑症和 FOR 的影响。
通过妇女学院医院（多伦多，加拿大）的癌症治疗后过渡期（ACTT）诊所，确定合格的参与者，征得他们的同意并将他们转介到 BounceBack®计划。计划参与包括完成自选的在线手册和接受受过培训的电话辅导员的支持。在干预前（基线）和干预后（6 个月和 12 个月时间点）收集了抑郁（PHQ-9）、焦虑（GAD-7）和 FOR（癌症复发恐惧量表，FCRI）的测量结果。对于每个心理社会测量，配对 t 检验比较了研究时间点之间的平均分数。通过调查收集了参与者的经验和看法。
从干预前到干预后，参与者的抑郁和焦虑测量结果显著改善。PHQ-9 和 GAD-7 的分数从中度降至轻度。FOR 的测量也显著改善，而 FCRI 子量表的 7 个特征中的 5 个（触发因素、严重程度、心理困扰、功能障碍、洞察力）的分数显著提高。参与者对干预的平均评分为 7（满分 10 分），表明满意度和有用性处于中等水平。
本研究表明，虚拟基于 CBT 的电话辅导计划可能是管理癌症幸存者抑郁、焦虑和复发恐惧的有效方法。
