School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.
The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Brisbane, Queensland, Australia.
Psychooncology. 2023 Sep;32(9):1385-1394. doi: 10.1002/pon.6189. Epub 2023 Jul 6.
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).
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.
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.
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.
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。
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。
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。
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。
