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管理癌症与有意义生活(CALM)对乳腺癌幸存者癌症复发恐惧的积极影响

Positive influence of managing cancer and living meaningfully (CALM) on fear of cancer recurrence in breast cancer survivors.

作者信息

Wang Menglian, Gan Chen, Zhao Jie, Li Wen, Yu Sheng, Yao Senbang, Tang Lingxue, Xu Jian, Cheng Huaidong

机构信息

Department of Oncology, The Second Affiliated Hospital of Anhui Medical University Hefei 230601, Anhui, China.

Shenzhen Clinical Medical School of Southern Medical University Shenzhen 518000, Guangdong, China.

出版信息

Am J Cancer Res. 2023 Jul 15;13(7):3067-3079. eCollection 2023.

Abstract

To evaluate the effectiveness and feasibility of managing cancer and living meaningfully (CALM), an intervention used to reduce the fear of cancer recurrence (FCR) in breast cancer survivors and improve their quality of life (QoL). A total of 103 breast cancer survivors were enrolled. Participants were randomly assigned to the CALM group or the care as usual (CAU) group. The participants completed a survey at baseline (T0) and after two (T1), four (T2), and six (T3) intervention sessions. The patients were assessed using the Cancer Worry Scale (CWS), Psychological Distress Thermometer (DT), Functional Assessment of Cancer Therapy-Breast (FACT-B) and Hospital Anxiety and Depression Scale (HADS). After the intervention, the CALM group showed a significant decrease in levels of FCR, distress, anxiety, and depression (χ=154.353, χ=130.292, χ=148.879, and χ=78.681; P<0.001, 0.001, 0.001, and 0.001, respectively) and an increased QoL (χ=122.822, P<0.001). Compared with the CAU group, the CALM group showed significant differences in FCR, distress, QoL, anxiety and depression (F=292.431, F=344.156, F=11.115, F=45.124, and F=16.155; P<0.001, P<0.001, P=0.01, P<0.001, and P<0.001, respectively). Negative correlations were found between CWS and FACT-B scores in the CALM group (T0: r=-0.6345, P<0.001; T1: r=-0.4127, P=0.0017; T2: r=-0.2919, P=0.0306; and T3: r=-0.3188, P=0.0177) and in the CAU group (T0: r=-0.7714, P<0.0001; T1: r=-0.6549, P<0.0001; T2: r=-0.5060, P=0.0002; and T3: r=-0.3151, P=0.0291). Thus, the CALM intervention reduced FCR, distress, anxiety and depression in breast cancer survivors and improved QoL.

摘要

为评估“管理癌症与有意义生活”(CALM)干预措施的有效性和可行性,该干预措施用于减轻乳腺癌幸存者对癌症复发的恐惧(FCR)并改善其生活质量(QoL)。总共招募了103名乳腺癌幸存者。参与者被随机分配到CALM组或常规护理(CAU)组。参与者在基线期(T0)以及两次(T1)、四次(T2)和六次(T3)干预疗程后完成一项调查。使用癌症担忧量表(CWS)、心理困扰温度计(DT)、癌症治疗功能评估 - 乳腺癌(FACT - B)和医院焦虑抑郁量表(HADS)对患者进行评估。干预后,CALM组的癌症复发恐惧、困扰、焦虑和抑郁水平显著降低(χ = 154.353,χ = 130.292,χ = 148.879,χ = 78.681;P分别<0.001、0.001、0.001和0.001),生活质量提高(χ = 122.822,P<0.001)。与CAU组相比,CALM组在癌症复发恐惧、困扰、生活质量、焦虑和抑郁方面存在显著差异(F = 292.431,F = 344.156,F = 11.115,F = 45.124,F = 16.155;P分别<0.001、P<0.001、P = 0.01、P<0.001和P<0.001)。在CALM组(T0:r = -0.6345,P<0.001;T1:r = -0.4127,P = 0.0017;T2:r = -0.2919,P = 0.0306;T3:r = -0.3188,P = 0.0177)和CAU组(T0:r = -0.7714,P<0.0001;T1:r = -0.6549,P<0.0001;T2:r = -0.5060,P = 0.0002;T3:r = -0.3151,P = 0.0291)中,发现CWS与FACT - B评分之间存在负相关。因此,CALM干预降低了乳腺癌幸存者的癌症复发恐惧、困扰、焦虑和抑郁,并改善了生活质量。

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