Tang Lili, Liu Quan-Xing, He Yuexia, Peng Huanzhi, Luo Maoyu, Zheng Hong, Zhang Qingling
Department of Thoracic Surgery, Second Affiliated Hospital of Army Medical University, Chongqing, China.
Department of Medical Psychology, Second Affiliated Hospital of Army Medical University, Chongqing, China.
Front Psychol. 2025 Aug 29;16:1511622. doi: 10.3389/fpsyg.2025.1511622. eCollection 2025.
To evaluate the efficacy of a multi-component intervention based on the Situational, Affective, Bodily, and Cognitive (SABC) stress-response model in reducing psychological distress and enhancing quality of life among post-thoracoscopic lung-cancer patients.
In this single-center, assessor-masked, parallel-group randomized controlled trial, 240 patients were randomized (1:1) to either a 12-month SABC intervention ( = 120) or standard care ( = 120) by means of computer-generated, sealed-envelope allocation. Outcome assessors were blinded to group assignment. The intervention comprised psycho-education, SABC-based skills training, a daily-habits checklist and scheduled follow-up. Psychological distress was measured with the NCCN Distress Thermometer (DT); quality of life was assessed with the EORTC QLQ-C30 at baseline and at 1, 3, 6, and 12 months post-surgery. Linear mixed-effects models were used, under both intention-to-treat (ITT) and per-protocol analyses, to test time-by-group interactions.
Time-by-group interactions favored the intervention group for physical (ITT: = 5.632, < 0.001; PP: = 6.084, < 0.001), role (ITT: = 3.325, = 0.010; PP: = 2.675, = 0.031) and emotional functioning (ITT: = 5.543, < 0.001; PP: = 5.566, < 0.001), and for the distress thermometer (ITT: = 3.791, = 0.005; PP: = 5.258, < 0.001). Social functioning improved in the ITT analysis only ( = 0.016); fatigue improved in the per-protocol analysis only ( = 0.008). No significant differences were observed for cognitive functioning, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhea, financial difficulties or global health status ( > 0.05).
A structured SABC-informed intervention significantly improves functional domains and reduces psychological distress in early-stage lung-cancer survivors after thoracoscopic surgery. Limitations include recruitment from a single tertiary center and exclusion of patients with severe comorbidities, which may limit generalisability to broader clinical populations.
A randomized controlled trial of a psychological-distress intervention in patients with lung cancer based on the SABC framework. https://www.chictr.org.cn/searchproj.html?title=&officialname=&subjectid=®status=®no=ChiCTR1900028487&secondaryid=&applier=&studyleader=&createyear=&sponsor=&secsponsor=&sourceofspends=&studyailment=&studyailmentcode=&studytype=&studystage=&studydesign=&recruitmentstatus=&gender=&agreetosign=&measure=&country=&province=&city=&institution=&institutionlevel=&intercode=ðicalcommitteesanction=&whetherpublic=&minstudyexecutetime=&maxstudyexecutetime=&btngo=btn, identifier: ChiCTR1900028487.
评估基于情境、情感、身体和认知（SABC）应激反应模型的多成分干预措施对减轻胸腔镜肺癌患者心理困扰及提高生活质量的疗效。
在这项单中心、评估者设盲、平行组随机对照试验中，240例患者通过计算机生成的密封信封分配法随机（1:1）分为12个月的SABC干预组（n = 120）或标准护理组（n = 120）。结果评估者对分组情况不知情。干预措施包括心理教育、基于SABC的技能培训、日常习惯清单和定期随访。采用NCCN苦恼温度计（DT）测量心理困扰；在基线、术后1、3、6和12个月时，使用欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）评估生活质量。在意向性分析（ITT）和符合方案分析中，均使用线性混合效应模型来检验组间时间交互作用。
组间时间交互作用表明，干预组在身体功能（ITT：F = 5.632，P < 0.001；PP：F = 6.084，P < 0.001）、角色功能（ITT：F = 3.325，P = 0.010；PP：F = 2.675，P = 0.031）和情感功能（ITT：F = 5.543，P < 0.001；PP：F = 5.566，P < 0.001）方面，以及在苦恼温度计评分上（ITT：F = 3.791，P = 0.005；PP：F = 5.258，P < 0.001）均更具优势。仅在意向性分析中社交功能有所改善（F = 0.016）；仅在符合方案分析中疲劳有所改善（F = 0.008）。在认知功能、恶心呕吐、疼痛、呼吸困难、失眠、食欲减退、便秘、腹泻、经济困难或总体健康状况方面未观察到显著差异（P > 0.05）。
基于SABC的结构化干预措施可显著改善早期肺癌胸腔镜手术后幸存者的功能领域并减轻心理困扰。局限性包括研究仅在单一三级中心招募患者且排除了患有严重合并症的患者，这可能会限制该研究结果在更广泛临床人群中的推广。
