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原发性脑肿瘤患者及其照护者的远程医疗了解脑瘤心理支持干预措施的效果评价:一项随机对照试验。

Evaluation of the telehealth making sense of brain tumor psychological support intervention for people with primary brain tumor and their caregivers: A randomized controlled trial.

机构信息

School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.

The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Brisbane, Queensland, Australia.

出版信息

Psychooncology. 2023 Sep;32(9):1385-1394. doi: 10.1002/pon.6189. Epub 2023 Jul 6.

Abstract

OBJECTIVE

This pragmatic randomized control trial aimed to evaluate clinical efficacy of the Making Sense of Brain Tumour program delivered via videoconferencing (Tele-MAST) for improving mental health and quality of life (QoL) relative to standard care in individuals with primary brain tumor (PBT).

METHOD

Adults with PBT experiencing at least mild distress (Distress Thermometer ≥4) and caregivers were randomly allocated to the 10-session Tele-MAST program or standard care. Mental health and QoL were assessed pre-intervention, post-intervention (primary endpoint), and 6-weeks and 6-months follow-up. The primary outcome was clinician-rated depressive symptoms on the Montgomery-Asberg Depression Rating Scale.

RESULTS

82 participants with PBT (34% benign, 20% lower-grade glioma, 46% high-grade glioma) and 36 caregivers were recruited (2018-2021). Controlling for baseline functioning, Tele-MAST participants with PBT had lower depressive symptoms at post-intervention (95% CI: 10.2-14.6, vs. 15.2-19.6, p = 0.002) and 6-weeks post-intervention (95% CI: 11.5-15.8 vs. 15.6-19.9, p = 0.010) than standard care, and were almost 4 times more likely to experience clinically reduced depression (OR, 3.89; 95% CI: 1.5-9.9). Tele-MAST participants with PBT also reported significantly better global QoL, emotional QoL and lower anxiety at post-intervention and 6-weeks post-intervention than standard care. There were no significant intervention effects for caregivers. At 6-months follow-up participants with PBT who received Tele-MAST reported significantly better mental health and QoL relative to pre-intervention.

CONCLUSIONS

Tele-MAST was found to be more effective for reducing depressive symptoms at post-intervention than standard care for people with PBT but not caregivers. Tailored and extended psychological support may be beneficial for people with PBT.

摘要

目的

本实用随机对照试验旨在评估通过视频会议(远程 MAST)提供的脑瘤认知干预方案(Tele-MAST)对改善原发性脑瘤(PBT)患者心理健康和生活质量(QoL)的临床疗效,与标准护理相比。

方法

患有 PBT 且至少有轻度困扰(痛苦温度计≥4)的成年人和照顾者被随机分配到 10 节 Tele-MAST 计划或标准护理组。在干预前、干预后(主要终点)以及 6 周和 6 个月随访时评估心理健康和 QoL。主要结局是蒙哥马利-阿斯伯格抑郁评定量表(Montgomery-Asberg Depression Rating Scale)评定的临床医生评定的抑郁症状。

结果

共招募了 82 名 PBT 患者(34%为良性肿瘤,20%为低级别胶质瘤,46%为高级别胶质瘤)和 36 名照顾者(2018-2021 年)。控制基线功能,Tele-MAST 组 PBT 患者在干预后(95%CI:10.2-14.6,vs.15.2-19.6,p=0.002)和干预后 6 周(95%CI:11.5-15.8 vs.15.6-19.9,p=0.010)时的抑郁症状较低,且出现临床抑郁缓解的可能性几乎高出 4 倍(比值比,3.89;95%CI:1.5-9.9)。Tele-MAST 组 PBT 患者在干预后和干预后 6 周时也报告了显著更好的总体 QoL、情绪 QoL 和较低的焦虑,与标准护理相比。照顾者没有显著的干预效果。在 6 个月随访时,接受 Tele-MAST 的 PBT 患者报告的心理健康和 QoL 明显优于干预前。

结论

与标准护理相比,Tele-MAST 被发现更能在干预后降低 PBT 患者的抑郁症状,但对照顾者无效。针对 PBT 患者的个性化和扩展的心理支持可能是有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/913b/10946492/43611f47823e/PON-32-1385-g001.jpg

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