Taub Chloe J, Zion Sean R, Ream Molly, Ramiller Allison, Heathcote Lauren C, Eich Geoff, Mendelsohn Meridithe, Birckbichler Justin, Ganz Patricia A, Cella David, Penedo Frank J, Antoni Michael, Shumay Dianne M
Department of Medicine, Division of General Internal Medicine and Population Science, University of Alabama at Birmingham Heersink School of Medicine.
Blue Note Therapeutics.
J Consult Clin Psychol. 2024 Nov;92(11):727-741. doi: 10.1037/ccp0000911.
Cancer-specific psychological interventions like cognitive behavioral stress management (CBSM) demonstrate distress (e.g., anxiety/depression) and quality of life (QoL) benefits. Digital formats can expand access.
Patients (80.6% female; 76.5% White; 25-80 years) with Stage I-III cancer and elevated anxiety within 6 months of treatment (surgery/chemotherapy/radiation/immunotherapy) receipt were randomized 1:1 to a 10-module CBSM or health education control digital app and completed questionnaires at Weeks 0, 4, 8, 12. Primary outcomes of greater group-level anxiety (PROMIS-A) and depression symptom (PROMIS-D) reductions for CBSM were met and published; this secondary report evaluates individual-level response results for these outcomes and outcomes beyond anxiety and depression. Chi-square tests compared responder proportions using PROMIS-A/PROMIS-D symptom categories and two levels (≥5/≥7.5) of T-score point reductions. Changes across conditions over time for stress (Perceived Stress Scale), cancer-specific distress (Impact of Event Scale-Intrusions), and QoL (Functional Assessment of Cancer Therapy-General) were analyzed using repeated measures linear mixed-effects modeling (N = 449). Patient Global Impression of Change-Well-being was also examined.
At Week 12, a greater proportion of CBSM (vs. control) participants reported normal-to-mild (vs. moderate-to-severe) PROMIS-A and PROMIS-D, and a greater proportion of CBSM participants at Week 8 or 12 had a ≥7.5 T-score reduction in PROMIS-A and a ≥5 T-score reduction in PROMIS-D (ps < .05). CBSM participants (vs. control) showed significantly greater reductions in Perceived Stress Scale and Impact of Event Scale-Intrusions and increases in Patient Global Impression of Change-Well-being and Functional Assessment of Cancer Therapy emotional and physical well-being (ps < .05), but not functional or social/family well-being.
Digitized CBSM benefits distress and QoL. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
认知行为压力管理（CBSM）等针对癌症的心理干预措施已证明对缓解痛苦（如焦虑/抑郁）和提高生活质量（QoL）有益。数字化形式可以扩大获取途径。
对接受治疗（手术/化疗/放疗/免疫治疗）6个月内患有I - III期癌症且焦虑情绪升高的患者（80.6%为女性；76.5%为白人；年龄25 - 80岁）按1:1随机分组，分别使用一款包含10个模块的CBSM数字应用程序或健康教育对照数字应用程序，并在第0、4、8、12周完成问卷调查。CBSM组在群体层面上更大程度地减轻焦虑（患者报告结果测量信息系统 - 焦虑，PROMIS - A）和抑郁症状（患者报告结果测量信息系统 - 抑郁，PROMIS - D）这一主要结果已得到验证并发表；这份次要报告评估了这些结果以及焦虑和抑郁之外的结果在个体层面的反应结果。卡方检验使用PROMIS - A/PROMIS - D症状类别和T分数降低的两个水平（≥5/≥7.5）比较反应者比例。使用重复测量线性混合效应模型（N = 449）分析压力（感知压力量表）、癌症特异性痛苦（事件影响量表 - 侵入性）和生活质量（癌症治疗功能评估 - 通用版）在不同条件下随时间的变化。还检查了患者对变化 - 幸福感的总体印象。
在第12周时，CBSM组（与对照组相比）有更大比例的参与者报告PROMIS - A和PROMIS - D为正常至轻度（而非中度至重度），并且在第8周或第12周时，CBSM组有更大比例的参与者PROMIS - A的T分数降低≥7.5，PROMIS - D的T分数降低≥5（p值 <.05）。CBSM组参与者（与对照组相比）在感知压力量表和事件影响量表 - 侵入性方面的降低幅度明显更大，在患者对变化 - 幸福感的总体印象以及癌症治疗功能评估的情绪和身体幸福感方面有所提高（p值 <.05），但在功能或社会/家庭幸福感方面没有变化。
数字化的CBSM对缓解痛苦和提高生活质量有益。（《心理学文摘数据库记录》（c）2024美国心理学会，保留所有权利）
