摘要
Objective: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(n=51)and a control group(n=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 P>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(T2β=−1.30,95%CI−1.87 to−0.72;T3β=−2.78,95%CI−3.51 to−2.05)and depression(T2β=−1.92,95%CI−2.78 to−1.06;T3β=−2.96,95%CI−4.05 to−1.87;all P<0.001).Moreover,the mindfulness score in the intervention group was significantly higher than that in the control group at T2(β=3.23,95%CI 0.73 to 5.72)and T3(β=8.06,95%CI 4.37 to 11.75;both P<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.Conclusion: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.
目的:单纯药物治疗改善乳腺癌患者焦虑抑郁等心理障碍的效果并不理想,需结合有效的心理社会干预手段。以正念为基础的干预可以缓解焦虑抑郁症状,促进健康行为。线上正念癌症康复训练授课形式灵活,引导患者在不同的环境中开展练习,有利于患者全程参与。本研究旨在评价线上4周正念癌症康复训练干预对乳腺癌患者焦虑抑郁及正念水平的干预效果,并评估乳腺癌患者对该康复训练干预项目的满意度。方法:采取随机对照试验研究方法,于2020年6月至2021年1月在湖南省长沙市某三级甲等医乳腺甲状腺外科病房招募103例乳腺癌患者,随机分为干预组(n=51)和对照组(n=52)。干预组接受线上4周正念癌症康复训练干预项目,内容包括每周1次、每次90 min的主题课程;对照组接受为期4周、每周1次的团体健康教育会议项目。在干预前(T1)、干预结束时(T2)和干预结束后1个月(T3)分别收集患者医院焦虑抑郁量表、正念注意觉知量表得分情况。在T2采用4周正念癌症康复训练项目满意度问卷,评价患者对干预项目的满意度。使用广义估计方程来评估干预前后组之间焦虑抑郁及正念水平变化的差异。结果:在T1,2组研究对象的人口学资料和各结局测量指标得分差异均无统计学意义(均P>0.05),基线资料具有可比性。调整协变量后,2组参与者各随访时间点的焦虑抑郁评分较干预前均有明显改善(均P<0.001),但试验组在改善乳腺癌患者焦虑(T2β=-1.30,95%CI-1.87~-0.72;T3β=-2.78,95%CI-3.51~-2.05)和抑郁(T2β=-1.92;95%CI-2.78~-1.06;T3β=-2.96,95%CI-4.05~-1.87)水平的效果均显著优于对照组(均P<0.001)。试验组在T2(β=3.23,95%CI 0.73~5.72)和T3(β=8.06,95%CI 4.37~11.75)时的正念水平得分均显著高于对照组(均P<0.05)。此外,患者对线上4周正念癌症康复训练项目、干预过程中的内容和安排满意度较高。结论:线上4周正念癌症康复训练干预能缓解乳腺癌患者的焦虑抑郁状态,提升正念水平,有助于促进其生活质量改善。作为一项短期心理干预,线上4周正念癌症康复训练干预在乳腺癌群体的满意度与适用性良好,在乳腺癌身心照护领域具有较好的应用前景。
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2024年第7期1130-1142,共13页
Journal of Central South University ：Medical Science
基金
supported by the National Science Fund for Distinguished Young Scholars(81703084)
the National Natural Science Foundation of General Program(82272924),and the Hunan Women’s Federation(19WTB03),China.
作者简介
First author:GU Can,Email:gucan_cs@csu.edu.cn,ORCID:0000-0001-5135-822X;Corresponding author:CHEN Xing,Email:ChenXingCSU@outlook.com,ORCID:0000-0001-8626-7432。
