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意义中心团体心理治疗后增强的意义是否介导了癌症幸存者抑郁症状的减轻?一项随机对照试验背景下的中介分析。

Does enhanced meaning after meaning-centered group psychotherapy mediate a reduction in depressive symptoms in cancer survivors? A mediation analysis in the context of a randomized controlled trial.

作者信息

Holtmaat Karen, van der Spek Nadia, Rijnhart Judith J M, Lissenberg-Witte Birgit, Breitbart William, Cuijpers Pim, Verdonck-de Leeuw Irma M

机构信息

Department of Clinical, Neuro-, and Developmental Psychology, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute (APH), Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.

Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.

出版信息

Support Care Cancer. 2024 Nov 28;32(12):832. doi: 10.1007/s00520-024-09039-4.

Abstract

PURPOSE

After meaning-centered group psychotherapy for cancer survivors (MCGP-CS), depressive symptoms tend to decrease. An enhanced sense of meaning may play a mediating role in this decrease. The aim of this study was to assess whether personal meaning mediates the relationship between MCGP-CS and depressive symptoms.

METHODS

Cancer survivors (n = 114) were randomly allocated to MCGP-CS or care as usual (CAU). The assessments were scheduled at baseline, postintervention, and at 3- and 6-month follow-up. Mediation models were estimated based on structural equation modeling. We computed the indirect effect of MCGP-CS on depressive symptoms at the 3-month follow-up through personal meaning, and other meaning-related mediators, measured postintervention.

RESULTS

A small but significant indirect effect of MCGP-CS on depressive symptoms at the 3-month follow-up was found through personal meaning postintervention (b = - 0.29, 95% bootstrap CI (- 0.63, - 0.03)). There were no significant indirect effects through the other meaning-related factors.

CONCLUSIONS

This study tentatively supports the MCGP-CS working model in that an enhanced sense of meaning as a result of MCGP-CS mediates a reduction in depressive symptoms. Personal meaning mediated a small effect of MCGP-CS on depressive symptoms. The longitudinal mediating effect of personal meaning occurred within a time period of 3 months after MCGP-CS.

RELEVANCE

MCGP-CS is a psychological intervention that supports cancer survivors in regaining or enhancing a sense of meaning in their lives. This enhanced sense of meaning is a protective factor against depressive symptoms.

TRIAL REGISTRATION

The RCT was registered in the Netherlands Trial Register (number NTR3571/NL3421) on August 10, 2012.

摘要

目的

在对癌症幸存者进行意义中心团体心理治疗(MCGP-CS)后,抑郁症状往往会减轻。意义感增强可能在这种减轻中起中介作用。本研究的目的是评估个人意义是否介导了MCGP-CS与抑郁症状之间的关系。

方法

将癌症幸存者(n = 114)随机分配至MCGP-CS组或常规护理(CAU)组。评估安排在基线、干预后以及3个月和6个月随访时进行。基于结构方程模型估计中介模型。我们计算了在3个月随访时,通过干预后测量的个人意义以及其他与意义相关的中介变量,MCGP-CS对抑郁症状的间接效应。

结果

在3个月随访时,发现通过干预后的个人意义,MCGP-CS对抑郁症状有微小但显著的间接效应(b = -0.29,95%自抽样置信区间(-0.63,-0.03))。通过其他与意义相关的因素未发现显著间接效应。

结论

本研究初步支持MCGP-CS的工作模型,即MCGP-CS导致的意义感增强介导了抑郁症状的减轻。个人意义介导了MCGP-CS对抑郁症状的微小效应。个人意义的纵向中介效应发生在MCGP-CS后的3个月内。

相关性

MCGP-CS是一种心理干预措施,可帮助癌症幸存者重新获得或增强生活中的意义感。这种增强的意义感是预防抑郁症状的保护因素。

试验注册

该随机对照试验于2012年8月10日在荷兰试验注册库(编号NTR3571/NL3421)注册。

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