基于网络的接纳与承诺疗法对肺癌患者健康相关结局的影响：一项可行性随机对照试验

Effects of Web-Based Acceptance and Commitment Therapy on Health-Related Outcomes Among Patients With Lung Cancer: A Feasibility Randomized Controlled Trial.

作者信息

Zhang Yalin, Liu Chunhua, Chen Xiaoli, Zhang Yun, Li Yunhuan, Hu Xiaolin

机构信息

Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.

Department of Obstetrics Nursing, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.

出版信息

Psychooncology. 2024 Dec;33(12):e70045. doi: 10.1002/pon.70045.

DOI:10.1002/pon.70045

PMID:39681977

Abstract

OBJECTIVE

To identify the feasibility, acceptability, and effectiveness of web-based acceptance and commitment therapy (ACT) on health-related outcomes in patients with lung cancer.

METHODS

A feasibility, prospective, parallel, individual-based, assessor-blinded randomized controlled trial was designed. This study was conducted at a third-level hospital in Sichuan Province, China. A total of 101 participants were enrolled and randomly assigned to usual care group or 7-weekly web-based acceptance and commitment therapy group. The primary outcome was feasibility and acceptability of the intervention, and the secondary outcomes including quality of life, psychological flexibility, anxiety, depression, fatigue, and sleep disturbance. Generalized estimating equations were used to evaluate the group differences. All analyses followed the principle of intention-to-treat.

RESULTS

Web-based ACT presented good feasibility and acceptability in this study, with an attrition rate of 13.86%, a median compliance rate of 71.43%, and a satisfaction rate of 65.9%. Compared with control group, participants in intervention group reported statistically significant increases in quality of life (MD = 15.10, 95% CI: [10.09, 20.11], d = 0.37), psychological flexibility (MD = -8.42, 95% CI: [-10.81, -6.03], d = -1.47), anxiety (MD = -1.27, 95% CI: [-2.50, -0.05], d = -0.44), depression (MD = -2.11, 95% CI: [-3.28, -0.95], d = -0.76), and sleep disturbance (MD = -1.85, 95% CI: [-3.10, -0.59], d = 0.13) at postintervention, however, the improvement in fatigue was not statistically significant (MD = -2.02, 95% CI: [-9.02, 4.98], d = -0.12).

CONCLUSIONS

Web-based ACT was an approach with good feasibility and acceptability, and it could effectively improve quality of life, psychological flexibility, anxiety, depression, and sleep disturbance in patients with lung cancer. In order to achieve better results, there is a need to design a more tailored intervention plan and a more operational platform.

摘要

目的

确定基于网络的接纳与承诺疗法（ACT）对肺癌患者健康相关结局的可行性、可接受性和有效性。

方法

设计了一项可行性、前瞻性、平行、基于个体、评估者盲法的随机对照试验。本研究在中国四川省的一家三级医院进行。共招募了101名参与者，并随机分配到常规护理组或为期7周的基于网络的接纳与承诺疗法组。主要结局是干预的可行性和可接受性，次要结局包括生活质量、心理灵活性、焦虑、抑郁、疲劳和睡眠障碍。使用广义估计方程评估组间差异。所有分析均遵循意向性分析原则。

结果

在本研究中，基于网络的ACT显示出良好的可行性和可接受性，损耗率为13.86%，中位依从率为71.43%，满意率为65.9%。与对照组相比，干预组参与者在干预后生活质量（MD = 15.10，95%CI：[10.09，20.11]，d = 0.37）、心理灵活性（MD = -8.42，95%CI：[-10.81，-6.03]，d = -1.47）、焦虑（MD = -1.27，95%CI：[-2.50，-0.05]，d = -0.44）、抑郁（MD = -2.11，95%CI：[-3.28，-0.95]，d = -0.76）和睡眠障碍（MD = -1.85，95%CI：[-3.10，-0.59]，d = 0.13）方面有统计学意义的改善，然而，疲劳的改善无统计学意义（MD = -2.02，95%CI：[-9.02，4.98]，d = -0.12）。