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一项新的数字干预措施(“FRAME”)促进原发性乳腺癌治疗女性恢复力的可行性随机对照试验。

Feasibility Randomised Controlled Trial of a New Digital Intervention ('FRAME') to Promote Resilience in Women Treated for Primary Breast Cancer.

作者信息

Cartwright Anna V, Krzyzanowski Hannah, Moss-Morris Rona, Smith Laura, Sawjani Yogini, Kristensen Camilla Böhme, Mukaty Nuvera, Norton Sam, Armes Jo, Hirsch Colette R

机构信息

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.

出版信息

Psychooncology. 2025 Jul;34(7):e70217. doi: 10.1002/pon.70217.

Abstract

OBJECTIVE

This study investigates the acceptability of a novel Cognitive Bias Modification for Interpretation (CBM-I) intervention, 'FRAME', to promote resilience in women who have completed active treatment for primary breast cancer and determines the feasibility of a full-scale randomised controlled trial.

METHODS

A two-armed, participant-blind, parallel groups randomised controlled trial of CBM-I versus a time-matched control. Participants were recruited from community organisations and social media. Measures of acceptability, feasibility, change in interpretation bias and clinical outcomes (resilience, mood and quality of life) were assessed at baseline (T0), 1-month post-randomisation (T1, end of intervention), 2-month (T2) and 4-month post-randomisation (T3).

RESULTS

Sixty-seven participants completed baseline assessment and were randomised to the FRAME CBM-I (n = 35) or control group (n = 32). Acceptability of CBM-I met pre-specified progression criteria, and 80% adhered to the CBM-I intervention. Between-group differences in interpretation bias at T1 demonstrated a moderate effect in favour of CBM-I on two measures of interpretation bias (SMD = 0.66 and 0.73). Effect size estimates suggest moderate treatment effects on resilience (SMD = 0.64) and small effects on mood, in favour of FRAME. No intervention-related adverse events were reported.

CONCLUSIONS

The study results provide strong support for the acceptability of a new online CBM-I intervention ('FRAME') to promote resilience in women treated for primary breast cancer and indicate that a full-scale trial is feasible. The study fulfiled all pre-specified progression criteria to advance to an efficacy trial, except meeting the recruitment target of 70 participants. Importantly, recruitment took place during the Covid-19 pandemic. Recommendations for future research are provided.

摘要

目的

本研究调查一种新型的用于解释的认知偏差修正(CBM-I)干预措施“FRAME”对已完成原发性乳腺癌积极治疗的女性增强心理复原力的可接受性,并确定全面随机对照试验的可行性。

方法

一项双臂、参与者盲法、平行组随机对照试验,比较CBM-I与时间匹配的对照组。参与者从社区组织和社交媒体招募。在基线(T0)、随机分组后1个月(T1,干预结束)、2个月(T2)和随机分组后4个月(T3)评估可接受性、可行性、解释偏差的变化以及临床结局(心理复原力、情绪和生活质量)。

结果

67名参与者完成了基线评估,并被随机分配到FRAME CBM-I组(n = 35)或对照组(n = 32)。CBM-I的可接受性符合预先设定的进展标准,80%的参与者坚持CBM-I干预。T1时两组在解释偏差上的差异显示,在两种解释偏差测量指标上,CBM-I有中度效应(标准化均数差分别为0.66和0.73)。效应量估计表明,对心理复原力有中度治疗效应(标准化均数差 = 0.64),对情绪有小效应,支持FRAME。未报告与干预相关的不良事件。

结论

研究结果有力支持了一种新的在线CBM-I干预措施(“FRAME”)对原发性乳腺癌治疗后女性增强心理复原力的可接受性,并表明全面试验是可行的。该研究满足了推进到疗效试验的所有预先设定的进展标准,但未达到招募70名参与者的目标。重要的是,招募是在新冠疫情期间进行的。为未来研究提供了建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f39a/12240892/4162e2f8420d/PON-34-e70217-g001.jpg

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