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与简短音乐对照相比,简短正念音频干预在前列腺癌每日放射治疗期间的实施准备情况及初始效果:一项随机试点研究。

Implementation Readiness and Initial Effects of a Brief Mindfulness Audio Intervention Compared With a Brief Music Control During Daily Radiation Therapy for Prostate Cancer: A Randomized Pilot Study.

作者信息

Victorson David, Mishra Kavita K, Sauer Joseph, Langford Grace, Maletich Carly, Horowitz Bruriah, Sauer Christina, Sejpal Samir V, Kalapurakal John

机构信息

Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

University of California San Francisco, San Francisco, CA, USA.

出版信息

Glob Adv Integr Med Health. 2024 Apr 30;13:27536130241249140. doi: 10.1177/27536130241249140. eCollection 2024 Jan-Dec.

Abstract

BACKGROUND

The most common and debilitating side effects of radiation therapy (RT) for prostate cancer (PC) are fatigue, sleep disturbance, anxiety, and depression. Previous research has reported palliative benefits from certain self-management approaches, such as mindfulness meditation.

OBJECTIVE

To develop, pre-test, and evaluate the feasibility, acceptability and initial benefit of brief, audio-based mindfulness delivered during daily RT for PC compared to a relaxing music control.

METHODS

Following intervention development, participants were randomized to either brief guided mindfulness audio recordings or a relaxing music control during daily RT. A pre-testing phase was first conducted to determine optimal program start time, length, and content most associated with retention. A final program (n = 26) was delivered daily, starting on day one of week 2 of RT and lasting 4 consecutive weeks. Feasibility was defined as ≥70% on enrollment rate, retention, and audio program adherence. Acceptability was measured with a 12-item post-study survey. A secondary focus compared between group changes on patient reported outcomes of fatigue, anxiety, depression, sleep disturbance, and related outcomes at baseline and follow up assessments. Descriptive statistics and general linear models were used.

RESULTS

Overall, 76% (n = 38) of approached men enrolled. Pre-testing retention rates were <70% while the final program's retention rate was 89%. The majority of acceptability criteria were met in both conditions, with relatively higher ratings in the mindfulness arm. Compared to music controls, mindfulness participants demonstrated significantly less uncertainty intolerance at 4-weeks ( = .046, d = .95); and significantly lower fatigue scores ( = .049, d = 1.3) and lower sleep disturbance scores ( = .035, d = 1.1) at the 3 months follow up.

CONCLUSION

The final intervention met feasibility and acceptability criteria. Pre-testing refinements played a key role for optimal program delivery and retention. Audio-based mindfulness delivered during RT for PC hold potential to help decrease RT-related physical and emotional side effects.

摘要

背景

前列腺癌放射治疗(RT)最常见且使人衰弱的副作用是疲劳、睡眠障碍、焦虑和抑郁。先前的研究报告了某些自我管理方法(如正念冥想)的姑息治疗益处。

目的

与放松音乐对照相比,开发、预测试并评估在前列腺癌每日放疗期间提供的简短音频正念疗法的可行性、可接受性和初步益处。

方法

在干预措施开发之后,参与者在每日放疗期间被随机分配到简短的引导式正念音频记录组或放松音乐对照组。首先进行了一个预测试阶段,以确定与留存率最相关的最佳项目开始时间、时长和内容。最终项目(n = 26)从放疗第2周的第1天开始每日进行,持续4周。可行性定义为入学率、留存率和音频项目依从性≥70%。通过一项12项的研究后调查来衡量可接受性。次要重点是在基线和随访评估中比较两组在患者报告的疲劳、焦虑、抑郁、睡眠障碍及相关结果方面的变化。使用描述性统计和一般线性模型。

结果

总体而言,76%(n = 38)的受访男性参与了研究。预测试的留存率<70%,而最终项目的留存率为89%。两种情况下大多数可接受性标准都得到了满足,正念组的评分相对较高。与音乐对照组相比,正念组参与者在4周时表现出显著更低的不确定性不耐受(p = .046,d = .95);在3个月随访时疲劳得分显著更低(p = .049,d = 1.3),睡眠障碍得分也更低(p = .035,d = 1.1)。

结论

最终干预措施符合可行性和可接受性标准。预测试的改进对最佳项目实施和留存起到了关键作用。在前列腺癌放疗期间提供的基于音频的正念疗法有潜力帮助减少放疗相关的身体和情绪副作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ece9/11062214/0bb73430f400/10.1177_27536130241249140-fig1.jpg

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