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瑜伽与心理综合干预减轻妇科、胃肠道和胸部癌症女性患者不良情绪的概念验证研究。

Proof-of-Concept of an Integrated Yoga and Psychological Intervention in Mitigating Distress Among Diverse Women With Gynecologic, Gastrointestinal, and Thoracic Cancers.

机构信息

University of Florida, Gainesville, FL, USA.

NorthShore University HealthSystem, Evanston, IL, USA.

出版信息

Integr Cancer Ther. 2024 Jan-Dec;23:15347354241283113. doi: 10.1177/15347354241283113.

Abstract

Fear of cancer recurrence (FCR), cancer-distress, depression, and anxiety are prevalent concerns among women with gynecologic and other understudied cancers, especially among women of color and lower socioeconomic status (SES). Evidence indicates that mind-body interventions are effective in reducing such distress. This study evaluates (1) proof-of-concept of an integrated group yoga and psychological intervention in alleviating distress among women with gynecologic, gastrointestinal, and thoracic cancers and (2) differences in efficacy across social and economic factors. One hundred twenty-five participants were enrolled in a 10-week, single-arm, integrated group intervention utilizing mindfulness meditation, psychotherapy skills, and yoga. They completed measures of FCR, cancer-distress, depression, and anxiety at baseline and following intervention. Mixed-linear models evaluated change in outcomes across the intervention and moderating effects of age, minority status, and SES among 51 participants with available data. Reductions in total ( = -2.06,  = .012) and somatic depressive symptoms ( = -1.79,  = .002) and state anxiety ( = -6.21,  = .005) were observed across the sample. Higher SES was associated with greater reductions in psychosocial distress related to FCR ( = -0.74,  = .050), and in total (b = -1.06, P = .049) and affective depressive symptoms ( = -0.76,  = .006). Women of color experienced greater declines in somatic symptoms compared to non-Hispanic White women ( = -2.71,  = .031), with women of color experiencing lower SES exhibiting greatest reduction in these symptoms ( = 1.73,  = .026). This study demonstrates proof-of-concept that an integrated psychological and yoga intervention may reduce depressive symptoms and state anxiety among women with gynecologic, gastrointestinal, and thoracic cancers, with racial and/or ethnic minority status and SES moderating some of these effects. Future research should examine intervention feasibility and acceptability among diverse women with cancer and evaluate efficacy using a randomized controlled trial design.Trial registration: ClinicalTrials.gov NCT03385577.

摘要

对癌症复发的恐惧(Fear of cancer recurrence,FCR)、癌症困扰、抑郁和焦虑是妇科和其他研究较少的癌症患者常见的担忧,尤其是在有色人种和社会经济地位较低的女性中。有证据表明,身心干预措施可有效减轻这种困扰。本研究评估了(1)综合团体瑜伽和心理干预减轻妇科、胃肠道和胸部癌症女性困扰的概念验证,以及(2)社会经济因素对疗效的差异。

125 名参与者参加了为期 10 周的单一臂综合团体干预,该干预采用正念冥想、心理治疗技能和瑜伽。他们在基线和干预后完成了对 FCR、癌症困扰、抑郁和焦虑的测量。在 51 名有可用数据的参与者中,混合线性模型评估了干预过程中结果的变化以及年龄、少数族裔地位和 SES 的调节作用。

在整个样本中,总( = -2.06,  = .012)和躯体抑郁症状( = -1.79,  = .002) 和状态焦虑( = -6.21,  = .005)减少。较高的 SES 与与 FCR 相关的心理社会困扰的更大减少有关( = -0.74,  = .050),与总(b = -1.06,P = .049)和情感抑郁症状( = -0.76,  = .006)有关。与非西班牙裔白人女性相比,有色人种女性的躯体症状下降更大( = -2.71,  = .031),SES 较低的有色人种女性的这些症状下降最大( = 1.73,  = .026)。

本研究证明,综合心理和瑜伽干预可能会减轻妇科、胃肠道和胸部癌症女性的抑郁症状和状态焦虑,种族和/或民族少数群体地位和 SES 调节了这些影响中的一些。未来的研究应该在不同的癌症女性中检查干预的可行性和可接受性,并使用随机对照试验设计评估疗效。

试验注册

ClinicalTrials.gov NCT03385577。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff26/11490981/4e04a72f9bf7/10.1177_15347354241283113-fig1.jpg

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