Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
University of Michigan, Department of Urology, Ann Arbor, MI, USA.
Contemp Clin Trials. 2023 Feb;125:107059. doi: 10.1016/j.cct.2022.107059. Epub 2022 Dec 21.
Although active surveillance (AS) is an increasingly adopted treatment paradigm for management of very low risk prostate cancer, many men and their partners face a variety of AS-related psychosocial stressors. Stressors may include anxiety and fear of progression, which may negatively affect short- and long-term psychosocial adjustment and influence early withdrawal from AS in order to seek definitive therapies such as surgery or radiation. Here we describe the protocol for an NCI-funded trial, which seeks to examine the efficacy of mindfulness training compared with a time/attention-matched health promotion control condition in a geographically generalizable sample of men on AS and their spouses.
Using a randomized, controlled, partially double-blinded study design, this study involves the delivery of 8 weeks of standardized mindfulness training (MBSR; mindfulness-based stress reduction) and patient reported outcomes over a 12-month period (proposed enrollment of 80 men on AS and spouses), compared with a health promotion control (proposed enrollment of 80 men on AS and spouses) that has been matched for time and attention. Baseline (T1) measures (e.g., anxiety, fear of progression, quality of life) are administered just prior to randomization to the two study arms, followed by repeated assessments at 2 months (T2), 6 months (T3) and 12 months (T4).
This study has the potential to offer men and their partners on AS with important educational and self-regulatory skills to better cope and adjust with known stressors related to being placed on this protocol.
尽管主动监测(AS)是管理极低风险前列腺癌的一种越来越被采用的治疗模式,但许多男性及其伴侣面临着各种与 AS 相关的心理社会压力源。压力源可能包括对进展的焦虑和恐惧,这可能会对短期和长期的心理社会适应产生负面影响,并促使他们提前退出 AS,转而寻求手术或放疗等确定性治疗。在这里,我们描述了一项由美国国家癌症研究所资助的试验方案,该试验旨在比较正念训练与时间/注意力匹配的健康促进对照组,在具有地理代表性的 AS 男性及其配偶样本中评估正念训练的疗效。
采用随机、对照、部分双盲研究设计,本研究涉及在 12 个月的时间内(拟招募 80 名 AS 男性及其配偶)提供 8 周标准化的正念训练(MBSR;正念减压)和患者报告结果,与健康促进对照组(拟招募 80 名 AS 男性及其配偶)进行比较,对照组在时间和注意力上进行了匹配。在两个研究臂随机分组之前,进行基线(T1)测量(例如,焦虑、对进展的恐惧、生活质量),随后在 2 个月(T2)、6 个月(T3)和 12 个月(T4)进行重复评估。
这项研究有可能为接受 AS 治疗的男性及其伴侣提供重要的教育和自我调节技能,以更好地应对和适应与接受该方案相关的已知压力源。