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正念认知疗法对改善乳腺癌患者焦虑症状和生活质量的有效性。

The Effectiveness of Mindfulness-Based Cognitive Therapy to Improve Anxiety Symptoms and Quality of Life in Breast Cancer Patients.

机构信息

Department of Psychiatry, Faculty of Medicine, Universitas Sebelas Maret, Muwardi Hospital, Surakarta, Indonesia.

Department of Surgery, Faculty of Medicine, Universitas Sebelas Maret, Muwardi Hospital, Surakarta, Indonesia.

出版信息

Asian Pac J Cancer Prev. 2024 Sep 1;25(9):3081-3086. doi: 10.31557/APJCP.2024.25.9.3081.

Abstract

BACKGROUND

Breast cancer patients often experience anxiety, impacting their Quality of Life (QOL) . Mindfulness-Based Cognitive Therapy (MBCT) is a 3rd generation psychotherapy from CBT combined with MBSR where mindfulness methods are carried out in a structured and scheduled manner, able to provide a pause between the stressor and the automatic response it causes. This study aimed to assess MBCT's effectiveness in alleviating anxiety and enhancing QOL in Stage III breast cancer patients undergoing chemotherapy, with mild-moderate anxiety disorders.

METHOD

The experimental research, conducted at Moewardi General Hospital Surakarta from March to June 2023, employed a quasi-experimental pretest-posttest control group design. Thirty subjects were divided into intervention (MBCT) and control (psychoeducation) groups. Participants completed demographic forms, disease history, and assessments using the Hospital Anxiety & Depression Scale (HADS-A) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30).

RESULT

There was a significant improvement in HADS-A scores in both groups (P <0.001) where the difference in the median HADS score in intervention group was higher compared to the control group. The effect of MBCT to the score improvement of HADS-A showed statistically significant results P=0.003 with HR 1.288. In the EORTC QLQ C30 Global score, the intervention group experienced a significant increase P<0.001, and in the control group, it did not significantly increase p=0.087 although multivariate analysis showed that MBCT was not significant in improving the global EORTC score. From the continued multivariate analysis of the EORTC QLQ C30 function, score improvement was significantly influenced by MBCT with P=0.035 and HR 3.086. Meanwhile, for the EORTC symptoms, score improvement was influenced by MBCT with P=0.005 and HR3.401.

CONCLUSION

There is a score improvement in HADS-A and EORTC with the provision of MBCT psychotherapy and with the provision of psychotherapy. However, the HADS and EORTC improvement scores were significantly higher with MBCT compared to psychotherapy alone.

摘要

背景

乳腺癌患者常伴有焦虑,影响其生活质量(QOL)。基于正念认知疗法(MBCT)是一种从 CBT 发展而来的第三代心理疗法,结合了 MBSR,正念方法以结构化和预定的方式进行,能够在压力源和自动反应之间提供一个停顿。本研究旨在评估 MBCT 在缓解接受化疗的 III 期乳腺癌患者轻度至中度焦虑障碍时的焦虑和提高生活质量的效果。

方法

这项于 2023 年 3 月至 6 月在苏拉卡尔塔莫华迪综合医院进行的实验研究采用了准实验前后测对照组设计。30 名参与者被分为干预(MBCT)和对照组(心理教育)。参与者填写人口统计学表格、疾病史,并使用医院焦虑抑郁量表(HADS-A)和欧洲癌症研究治疗组织生活质量问卷核心 30 分(EORTC QLQ-C30)进行评估。

结果

两组的 HADS-A 评分均有显著改善(P<0.001),干预组中位数 HADS 评分的差异高于对照组。MBCT 对 HADS-A 评分改善的效果具有统计学意义(P=0.003,HR 1.288)。在 EORTC QLQ C30 整体评分方面,干预组显著增加(P<0.001),而对照组则没有显著增加(p=0.087),尽管多变量分析显示 MBCT 对整体 EORTC 评分的改善并不显著。从 EORTC QLQ C30 功能的进一步多变量分析来看,MBCT 显著影响了评分的改善(P=0.035,HR 3.086)。同时,对于 EORTC 症状,MBCT 显著影响了评分的改善(P=0.005,HR3.401)。

结论

提供 MBCT 心理治疗和心理教育后,HADS-A 和 EORTC 的评分均有改善。然而,与单独提供心理教育相比,MBCT 显著提高了 HADS 和 EORTC 的改善评分。

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