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一项为期4周的基于网络的正念减压癌症康复计划对乳腺癌患者焦虑、抑郁及正念水平的影响

Effects of a 4week internetdelivered mindfulnessbased cancer recovery program on anxiety, depression, and mindfulness among patients with breast cancer.

作者信息

Gu Can, Peng Yunyun, Peng Yueyang, Lin Sulan, Yao Juqin, Chen Xing

机构信息

Xiangya School of Nursing, Central South University, Changsha 410013.

College of Nursing, Xinjiang Medical University, Urumqi 830054.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Jul 28;49(7):1130-1142. doi: 10.11817/j.issn.1672-7347.2024.240028.

Abstract

OBJECTIVES

The efficacy of monotherapy in alleviating psychological disorders like anxiety and depression among breast cancer patients is suboptimal, necessitating effective psychosocial interventions. Mindfulness-based interventions have been shown to mitigate anxiety-depression symptoms and encourage beneficial behaviors. The online mindfulness-based cancer recovery (MBCR) offers flexibility and guides practice across various settings, facilitating full patient engagement. This study amis to analyze the impact of a 4-week internet-delivered mindfulness-based cancer recovery program on anxiety, depression, and mindfulness among Chinese patients with breast cancer, and to evaluate the degree of satisfaction breast cancer patients experienced after participating in this program.

METHODS

This study utilized a two-armed, parallel, randomized controlled trial design. A total of 103 patients with breast cancer from June 2020 to January 2021 in the ward of Breast and Thyroid Surgery of a tertiary hospital in Changsha, Hunan Province were selected and randomly assigned to an intervention group (=51) and a control group (=52). The intervention group participated in an internet-delivered mindfulness-based cancer recovery program, which was delivered once a week for 4 weeks. Meanwhile, the control group received weekly group health education for 4 weeks. The outcomes of hospital anxiety and depression scale and mindfulness Attention Awareness Scale were evaluated at 3 distinct time points: Baseline (T1), postintervention (T2), and 1-month follow-up (T3). The satisfaction questionnaire of 4-week mindful cancer rehabilitation training program was used at T2 to evaluate patients' satisfaction with the intervention program. Generalized estimation equations were used to assess differences in anxiety, depression and mindfulness levels between groups before and after the intervention.

RESULTS

There were no statistically significant differences in demographic data and outcome index scores between the 2 groups at T1 (all >0.05), indicating that the 2 groups were comparable. The generalized estimating equation analyses showed that the intervention group had significantly better improvement in outcomes compared to the control group, particularly for anxiety (T2 =-1.30, 95% -1.87 to -0.72; T3 =-2.78, 95% -3.51 to -2.05) and depression (T2 =-1.92, 95% -2.78 to -1.06; T3 =-2.96, 95% -4.05 to -1.87; all <0.001). Moreover, the mindfulness score in the intervention group was significantly higher than that in the control group at T2 (=3.23, 95% 0.73 to 5.72) and T3 (=8.06, 95% 4.37 to 11.75; both <0.05). In addition, patients in the intervention group were satisfied with the 4-week mindfulness-based cancer recovery intervention and teaching/learning activities used to implement the program.

CONCLUSIONS

In patients with breast cancer, the 4-week internet-delivered mindfulness-based cancer recovery program, as a low-threshold, short-term mental health intervention, has a positive effect on reducing anxiety and depression and improving mindfulness levels. This program holds great promise as a tool for clinical nursing practice, given the high satisfaction and applicability.

摘要

目的

单一疗法在缓解乳腺癌患者焦虑和抑郁等心理障碍方面效果欠佳,因此需要有效的心理社会干预措施。基于正念的干预已被证明可减轻焦虑抑郁症状并鼓励有益行为。基于互联网的正念癌症康复(MBCR)具有灵活性,可指导患者在各种场景下进行练习,促进患者充分参与。本研究旨在分析为期4周的基于互联网的正念癌症康复项目对中国乳腺癌患者焦虑、抑郁和正念的影响,并评估乳腺癌患者参与该项目后的满意度。

方法

本研究采用双臂、平行、随机对照试验设计。选取2020年6月至2021年1月在湖南省长沙市某三级医院乳腺甲状腺外科病房的103例乳腺癌患者,随机分为干预组(n = 51)和对照组(n = 52)。干预组参加基于互联网的正念癌症康复项目,每周进行1次,共4周。同时,对照组接受为期4周的每周1次的团体健康教育。在3个不同时间点评估医院焦虑抑郁量表和正念注意觉知量表的结果:基线(T1)、干预后(T2)和1个月随访(T3)。在T2时使用为期4周的正念癌症康复训练项目满意度问卷评估患者对干预项目的满意度。采用广义估计方程评估干预前后两组焦虑、抑郁和正念水平的差异。

结果

两组在T1时的人口统计学数据和结局指标得分无统计学显著差异(均P>0.05),表明两组具有可比性。广义估计方程分析显示,与对照组相比,干预组的结局改善显著更好,尤其是焦虑(T2 = -1.30,95%CI -1.87至-0.72;T3 = -2.78,95%CI -3.51至-2.05)和抑郁(T2 = -1.92,95%CI -2.78至-1.06;T3 = -2.96,95%CI -4.05至-1.87;均P<0.001)。此外,干预组在T2时的正念得分显著高于对照组(P = 3.23,95%CI 0.73至5.72)和T3时(P = 8.06,95%CI 4.37至11.75;均P<0.05)。此外,干预组患者对为期4周的基于正念的癌症康复干预及实施该项目所采用的教学活动感到满意。

结论

对于乳腺癌患者,为期4周的基于互联网的正念癌症康复项目作为一种低门槛短期心理健康干预措施,在减轻焦虑和抑郁以及提高正念水平方面具有积极作用。鉴于其高满意度和适用性,该项目作为临床护理实践工具具有很大前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d81/11495976/08ad291d8e7e/ZhongNanDaXueXueBaoYiXueBan-49-7-1129-g001.jpg

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