Walsh Leah E, Dunderdale Laura, Horick Nora, Temel Jennifer S, Greer Joseph A, Jacobs Jamie M
Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Massachusetts General Hospital, Boston, Massachusetts, USA.
Psychooncology. 2024 Dec;33(12):e70049. doi: 10.1002/pon.70049.
A recent randomized trial of a group psychosocial telehealth intervention (STRIDE) improved anxiety, depression, quality of life (QOL), symptom distress, coping, and self-efficacy to manage symptoms related to taking adjuvant endocrine therapy (AET) in women with non-metastatic hormone receptor-positive breast cancer. This study examined whether changes in coping and self-efficacy mediated intervention effects on anxiety, depression, QOL, and symptom distress.
Women (N = 100) were recruited between 10/2019-06/2021 from Massachusetts General Hospital and were randomized to STRIDE or to the medication monitoring control group. Participants completed self-report measures of anxiety and depression (Hospital Anxiety and Depression Scale), QOL (Functional Assessment of Cancer Therapy-Breast Cancer scale), symptom distress (Breast Cancer Prevention Trial Symptom Scale), coping (Measure of Current Status-Part A), and self-efficacy (Self Efficacy for Managing AET Symptoms) at baseline and 24-week follow-up. Mediated regression models tested whether changes in coping ability and self-efficacy mediated the intervention effects on anxiety, depression, QOL, and symptom distress, controlling for key variables.
Improvements in coping across the 24-week study period mediated the effect of STRIDE on anxiety symptoms (indirect effect, B = -0.61, SE = 0.28, 95% CI: -1.28, -0.17), depressive symptoms (indirect effect, B = -0.50, SE = 0.21, 95% CI: -0.97, -0.15), and QOL (indirect effect, B = 3.80, SE = 1.25, 95% CI: 1.54, 6.49), but not symptom distress. Changes in self-efficacy did not mediate improvements in any of the proposed outcomes.
Coping is an essential component of a brief group psychosocial intervention that drives improvements in mood and QOL for women with non-metastatic hormone receptor-positive breast cancer taking AET.
NCT03837496.
最近一项关于团体心理社会远程医疗干预（STRIDE）的随机试验改善了非转移性激素受体阳性乳腺癌女性在接受辅助内分泌治疗（AET）时的焦虑、抑郁、生活质量（QOL）、症状困扰、应对能力和管理症状的自我效能感。本研究探讨了应对能力和自我效能感的变化是否介导了干预对焦虑、抑郁、生活质量和症状困扰的影响。
2019年10月至2021年6月期间，从麻省总医院招募了100名女性，并将她们随机分为STRIDE组或药物监测对照组。参与者在基线和24周随访时完成了焦虑和抑郁（医院焦虑抑郁量表）、生活质量（癌症治疗功能评估-乳腺癌量表）、症状困扰（乳腺癌预防试验症状量表）、应对能力（现状测量-A部分）和自我效能感（管理AET症状的自我效能感）的自我报告测量。中介回归模型检验了应对能力和自我效能感的变化是否介导了干预对焦虑、抑郁、生活质量和症状困扰的影响，并控制了关键变量。
在24周的研究期间，应对能力的改善介导了STRIDE对焦虑症状（间接效应，B = -0.61，SE = 0.28，95% CI：-1.28，-0.17）、抑郁症状（间接效应，B = -0.50，SE = 0.21，95% CI：-0.97，-0.15）和生活质量（间接效应，B = 3.80，SE = 1.25，95% CI：1.54，6.49）的影响，但未介导对症状困扰的影响。自我效能感的变化并未介导任何一项预期结果的改善。
应对能力是一种简短的团体心理社会干预的重要组成部分，它能改善接受AET的非转移性激素受体阳性乳腺癌女性的情绪和生活质量。
NCT03837496。
