Gong Rui, Heller Aaron, Penedo Frank J
Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
Int J Behav Med. 2024 Feb 20. doi: 10.1007/s12529-024-10270-w.
Social well-being impacts cancer patients' health-related quality of life (HRQOL) and coping style. This secondary analysis was conducted to examine whether advanced prostate cancer survivors who had experienced low social well-being would benefit from a web-based cognitive behavioral stress management (CBSM) intervention.
APC survivors (N = 192) who had received androgen deprivation therapy (ADT) were randomized to a 10-week CBSM or a health promotion (HP) control condition. A subsample of participants (n = 61) with low pre-intervention SWB (measured by social support from and relationship satisfaction with family and friends) was included in the study. Multilevel models compared participants' PC-specific quality of life (sexual, hormonal, urinary), affect-based psychosocial burden (cancer-related anxiety and distress), and coping strategies at baseline, 6 months, and 12 months. Covariates were included in all models as appropriate.
Participants randomized to the CBSM condition showed significantly greater improvements in fear of cancer recurrence and cancer-related intrusive thoughts than those in the HP control condition. A significant condition by time interaction was also found, indicating that CBSM improved participants' PC-related fear in both short- (6 months) and long-term (12 months). However, the CBSM intervention did not significantly impact APC-related symptom burden. Only for the urinary domain, clinically meaningful changes (CBSM vs HP) were observed. In addition, all participants, regardless of condition, reported less coping (e.g., emotion-, problem- and avoidance-focused) over time.
As predicted, the CBSM intervention improved several affect-based psychosocial outcomes for APC survivors with low baseline SWB.
社会幸福感会影响癌症患者的健康相关生活质量（HRQOL）和应对方式。本二次分析旨在研究社会幸福感较低的晚期前列腺癌幸存者是否能从基于网络的认知行为压力管理（CBSM）干预中获益。
接受雄激素剥夺治疗（ADT）的晚期前列腺癌（APC）幸存者（N = 192）被随机分为为期10周的CBSM组或健康促进（HP）对照组。研究纳入了干预前社会幸福感较低（通过来自家人和朋友的社会支持以及与他们的关系满意度来衡量）的参与者子样本（n = 61）。多水平模型比较了参与者在基线、6个月和12个月时前列腺癌特定的生活质量（性、激素、泌尿方面）、基于情感的心理社会负担（癌症相关焦虑和痛苦）以及应对策略。所有模型均酌情纳入协变量。
随机分配到CBSM组的参与者在对癌症复发的恐惧和癌症相关侵入性思维方面的改善显著大于HP对照组的参与者。还发现了一个显著的组间与时间交互作用，表明CBSM在短期（6个月）和长期（12个月）均改善了参与者与前列腺癌相关的恐惧。然而，CBSM干预对与APC相关的症状负担没有显著影响。仅在泌尿领域观察到了具有临床意义的变化（CBSM组与HP组相比）。此外，随着时间的推移，所有参与者，无论处于何种组，报告的应对方式（如情感聚焦、问题聚焦和回避聚焦）都减少了。
正如预期的那样，CBSM干预改善了基线社会幸福感较低的APC幸存者的几个基于情感的心理社会结局。
