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正念对有认知主诉的乳腺癌幸存者癌症相关认知障碍的影响。

The impact of mindfulness on cancer-related cognitive impairment in breast cancer survivors with cognitive complaints.

作者信息

Melis Michelle, Schroyen Gwen, Leenaerts Nicolas, Smeets Ann, Sunaert Stefan, Van der Gucht Katleen, Deprez Sabine

机构信息

Department of Imaging and Pathology, Leuven Brain Institute, Translational MRI, Catholic University Leuven, Leuven, Belgium.

Research Foundation Flanders (FWO), Flanders, Belgium.

出版信息

Cancer. 2023 Apr 1;129(7):1105-1116. doi: 10.1002/cncr.34640. Epub 2023 Jan 10.

Abstract

BACKGROUND

Interventions that target cancer-related cognitive impairment (CRCI) to improve the quality of life of cancer survivors are needed. In this study, the potential of a mindfulness-based intervention to reduce CRCI in breast cancer survivors, compared with physical training and a wait list control group, was investigated.

METHODS

Breast cancer survivors with cognitive complaints (N = 117) were randomly allocated to a mindfulness (n = 43), physical training (n = 36), or wait list control condition (n = 38). Participants completed neuropsychological tests and questionnaires before the intervention, immediately after, and 3 months after intervention. The primary outcome measure was the change in cognitive complaints over time. Secondary outcomes were objective cognitive impairment and psychological well-being. All outcomes were compared between groups over time using linear mixed models, including participants with missing values.

RESULTS

Of the 117 included participants, 96 completed the three assessments. Participants in the three groups reported decreased cognitive complaints after intervention, without group differences. There were no between-group differences in objective cognitive impairment after intervention compared with baseline. Compared with the wait list control group, participants reported increased mindfulness skills and reduced emotional distress after mindfulness and reduced emotional distress and fatigue after physical training.

CONCLUSION

Contrary to the hypothesis, all groups reported an improvement in cognitive complaints over time. It is suggested that priming and acknowledgment of CRCI might alter the experience of cognitive impairment. Additionally, both mindfulness-based intervention and physical training can improve psychological well-being of breast cancer survivors with cognitive complaints.

摘要

背景

需要采取干预措施来改善癌症幸存者的生活质量,以应对与癌症相关的认知障碍(CRCI)。在本研究中,我们调查了与体育锻炼和等待名单对照组相比,基于正念的干预措施在降低乳腺癌幸存者CRCI方面的潜力。

方法

有认知主诉的乳腺癌幸存者(N = 117)被随机分配到正念组(n = 43)、体育锻炼组(n = 36)或等待名单对照组(n = 38)。参与者在干预前、干预后立即以及干预后3个月完成神经心理学测试和问卷调查。主要结局指标是认知主诉随时间的变化。次要结局是客观认知障碍和心理健康状况。使用线性混合模型对所有结局在不同组之间随时间进行比较,包括有缺失值的参与者。

结果

在纳入的117名参与者中,96名完成了三项评估。三组参与者在干预后报告认知主诉减少,无组间差异。与基线相比,干预后客观认知障碍无组间差异。与等待名单对照组相比,参与者报告在进行正念训练后正念技能增强、情绪困扰减轻,在进行体育锻炼后情绪困扰和疲劳减轻。

结论

与假设相反,所有组随时间推移认知主诉均有改善。提示对CRCI的启动和认知可能会改变认知障碍的体验。此外,基于正念的干预和体育锻炼均可改善有认知主诉的乳腺癌幸存者的心理健康状况。

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