接受与承诺疗法对质子和重离子治疗的癌症患者心理康复的疗效：一项非随机对照试验。

Efficacy of acceptance and commitment therapy on psychological rehabilitation in cancer patients treated with proton and heavy ion therapy: a non-randomized controlled trial.

作者信息

Qin Fei, Zhu Yu, Wang Shuman, Zhang Lijuan, Wang Ziying, Wan Hongwei

机构信息

Department of Nursing, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Fudan University Cancer Hospital, Shanghai, China.

出版信息

Support Care Cancer. 2025 Jan 7;33(1):73. doi: 10.1007/s00520-024-09126-6.

DOI:10.1007/s00520-024-09126-6

PMID:39762641

Abstract

OBJECTIVE

To develop an appropriate intervention utilizing acceptance and commitment therapy (ACT) tailored specifically for cancer patients undergoing radiotherapy, and to investigate its impact on hope, psychological resilience, psychological flexibility, and psychological distress among cancer patients receiving proton and heavy ion therapy.

METHODS

Eighty participants were allocated into an intervention group (n = 40) or a control group (n = 40) based on their admission time. The control and intervention groups underwent a 3-week health education program, with the intervention group additionally participating in a 3-week, 6-session acceptance and commitment therapy (ACT) group psychological intervention. Discrepancies in hope levels, psychological resilience, psychological flexibility, and psychological distress between the two groups were assessed at baseline, post-intervention, and a 3-month follow-up using linear mixed-effects analysis (LMM).

RESULTS

LMM analyses revealed that at the end of the intervention, scores for hope and psychological resilience were higher in the intervention group compared to the control group (P = 0.025, P = 0.003), and scores for psychological flexibility were lower in the intervention group (P = 0.001). Furthermore, at the 3-month follow-up, HHI scores remained higher in the intervention group compared to the control group (P = 0.015). In contrast, scores for psychological flexibility and psychological distress were lower in the intervention group (P = 0.001, P = 0.001). These differences persisted even after adjusting for baseline values.

CONCLUSION

A psychological intervention program based on the ACT model of treatment helps to promote psychological recovery in cancer patients with radiotherapy. Evidence is provided for the effectiveness of positive clinical psychological interventions.

TRIAL REGISTRATION

The study was registered in the Chinese Clinical Trial Registry (ChiCTR2300068349) on 15th February, 2023.

摘要

目的

开发一种专门为接受放疗的癌症患者量身定制的、运用接纳与承诺疗法（ACT）的恰当干预措施，并调查其对接受质子和重离子治疗的癌症患者的希望、心理韧性、心理灵活性及心理困扰的影响。

方法

80名参与者根据入院时间被分为干预组（n = 40）和对照组（n = 40）。对照组和干预组都接受为期3周的健康教育项目，干预组还额外参加为期3周、共6节的接纳与承诺疗法（ACT）团体心理干预。在基线、干预后及3个月随访时，使用线性混合效应分析（LMM）评估两组在希望水平、心理韧性、心理灵活性及心理困扰方面的差异。

结果

线性混合效应分析显示，在干预结束时，干预组的希望和心理韧性得分高于对照组（P = 0.025，P = 0.003），干预组的心理灵活性得分低于对照组（P = 0.001）。此外，在3个月随访时，干预组的HHI得分仍高于对照组（P = 0.015）。相比之下，干预组的心理灵活性和心理困扰得分较低（P = 0.001，P = 0.001）。即使在调整基线值后，这些差异仍然存在。