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乳腺癌康复期的心理干预:一项比较结构性短期心理治疗与非特异性团体讨论的随机对照试验。

Psychological interventions during breast cancer rehabilitation: a randomized controlled trial comparing structured short-term psychotherapy versus non-specific group discussion.

机构信息

Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.

VAMED Rehaklinik Ahrenshoop, Dorfstrasse 55, 18347, Ahrenshoop, Germany.

出版信息

BMC Cancer. 2023 Nov 21;23(1):1133. doi: 10.1186/s12885-023-11576-w.

Abstract

PURPOSE

Psycho-oncological treatment is recommended in cancer rehabilitation as it improves fatigue, anxiety, depression, and quality of life in breast cancer patients. The aim of our study was to compare a structured short-term psychotherapy and a non-specific group discussion provided during breast cancer rehabilitation.

METHODS

Breast cancer patients were randomly assigned to structured group short-term psychotherapy or a non-specific group discussion during breast cancer rehabilitation. The patients completed questionnaires at the beginning and end of rehabilitation and three months after rehabilitation. The primary outcome was anxiety. Secondary outcomes were depression, distress, fatigue and health-related quality of life domains.

RESULTS

In total, 160 patients (80 in both groups) were recruited and included in the analysis. There was no significant difference between both groups in the primary outcome anxiety at the end of rehabilitation (difference = -0.2; 95% CI -1.2 to 0.7) and three months after rehabilitation (difference = 0.2; 95% CI -0.9 to 1.3) and in any secondary outcome. Patients in the short-term psychotherapy group with high anxiety levels at baseline reported fewer depressive symptoms at the end of rehabilitation.

CONCLUSIONS

Our study showed no difference between structured short-term psychotherapy and a non-specific group discussion. Patients with high baseline anxiety levels were more likely to benefit from short-term structured psychotherapy. Early identification of this subgroup and symptoms of mental illness should occur after initial treatment in breast cancer patients in order to offer a structured treatment for anxiety and depressive symptoms during rehabilitation.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS00017571; 08/07/2019).

摘要

目的

在癌症康复中推荐心理肿瘤学治疗,因为它可以改善乳腺癌患者的疲劳、焦虑、抑郁和生活质量。我们的研究目的是比较癌症康复期间提供的结构化短期心理治疗和非特异性小组讨论。

方法

乳腺癌患者在癌症康复期间随机分配至结构化小组短期心理治疗或非特异性小组讨论。患者在康复开始时、结束时和康复后三个月完成问卷。主要结局是焦虑。次要结局是抑郁、痛苦、疲劳和健康相关生活质量领域。

结果

共招募了 160 名患者(每组 80 名)并纳入分析。在康复结束时(差异=-0.2;95%CI-1.2 至 0.7)和康复后三个月(差异=0.2;95%CI0.9 至 1.3),以及任何次要结局方面,两组之间主要结局焦虑均无显著差异。基线时焦虑水平较高的短期心理治疗组患者在康复结束时报告的抑郁症状较少。

结论

我们的研究表明,结构化短期心理治疗和非特异性小组讨论之间没有差异。基线时焦虑水平较高的患者更有可能从短期结构化心理治疗中受益。在乳腺癌患者初始治疗后,应早期识别出这一小亚组和精神疾病症状,以便在康复期间提供针对焦虑和抑郁症状的结构化治疗。

试验注册

德国临床试验注册处(DRKS00017571;2019 年 8 月 7 日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528a/10664677/f889ec7cc9f7/12885_2023_11576_Fig1_HTML.jpg

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