运用表达性写作改善癌症照顾者和患者的健康：一项随机对照可行性试验。

Using expressive writing to improve cancer caregiver and patient health: A randomized controlled feasibility trial.

机构信息

Department of Psychology, Stanford University, Building 420, 450 Serra Mall, Stanford, CA, 94305, United States.

出版信息

Eur J Oncol Nurs. 2024 Jun;70:102578. doi: 10.1016/j.ejon.2024.102578. Epub 2024 Mar 21.

DOI:10.1016/j.ejon.2024.102578

PMID:38522170

Abstract

PURPOSE

This study examined the feasibility and preliminary efficacy of Expressive Writing (EW) in improving informal cancer caregiver (IC) and patient health, and enhancing ICs' emotion regulation.

METHOD

Fifty-eight breast cancer ICs and patients participated in a randomized controlled feasibility trial of remote EW. ICs were randomly assigned to the EW or control group and completed 3 weekly writing sessions. ICs and patients completed health and emotion regulation assessments at baseline, intervention completion, and 3 months post-intervention. Screening, recruitment, assessment process, randomization, retention, treatment adherence, and treatment fidelity were computed for feasibility. Effect sizes were calculated using the PROMIS Depression Short Form, RAND Short Form 36 Health Survey, Breast Cancer Prevention Trial Hormonal Symptom checklist, healthcare utilization, and the Emotion Regulation Questionnaire for efficacy.

RESULTS

Of the 232 interested individuals, 82 were screened, and 60 enrolled (6 monthly). Two individuals withdrew and 19 were lost to follow-up, leaving 39 individuals. ICs completed at least one assessment and two sessions, and patients completed at least two assessments. All sessions were administered as intended. ICs generally followed instructions (88%-100%), wrote the full time (66.7%-100%), and were engaged (M(SD) = 3.00(1.29)-4.00(0.00)). EW had small-to-medium effects in improving IC health (g = -0.27-0.04) and small-to-large effects in improving patient health (g = -0.28-0.86). EW moderately decreased suppression (g = 0.53-0.54) and slightly increased reappraisal, at least 3 months post-intervention (g = -0.34-0.20).

CONCLUSIONS

Remote EW may be feasible with cancer ICs and improve cancer IC and patient health. However, it can benefit from additional retention strategies and rigorous testing.

TRIAL REGISTRATION

CenterWatch Clinical Trials Listing Service (#TX217874); ClinicalTrials.gov (#NCT06123416).

摘要

目的

本研究旨在探讨表达性写作（EW）在改善非正式癌症照顾者（IC）和患者健康、增强 IC 情绪调节方面的可行性和初步疗效。

方法

58 名乳腺癌 IC 和患者参与了一项远程 EW 的随机对照可行性试验。IC 被随机分配到 EW 或对照组，并完成了 3 周的写作课程。IC 和患者在基线、干预完成和干预后 3 个月时完成健康和情绪调节评估。计算了可行性的筛查、招募、评估过程、随机化、保留率、治疗依从性和治疗保真度。使用 PROMIS 抑郁短表、RAND 短期 36 健康调查、乳腺癌预防试验激素症状清单、医疗保健利用和情绪调节问卷评估疗效，计算效应大小。

结果

在 232 名感兴趣的个体中，有 82 人接受了筛查，有 60 人入组（每月 6 人）。有 2 人退出，19 人失访，留下 39 人。IC 至少完成了一次评估和两次课程，患者至少完成了两次评估。所有课程均按预期进行。IC 通常遵循指令（88%-100%），按时完成写作（66.7%-100%），并保持参与（M(SD) = 3.00(1.29)-4.00(0.00)）。EW 在改善 IC 健康方面具有小到中等的效果（g = -0.27-0.04），在改善患者健康方面具有小到较大的效果（g = -0.28-0.86）。EW 在干预后至少 3 个月时适度降低了抑制（g = 0.53-0.54），并略微增加了再评价（g = -0.34-0.20）。