Does enhanced meaning after meaning-centered group psychotherapy mediate a reduction in depressive symptoms in cancer survivors? A mediation analysis in the context of a randomized controlled trial.

IF 2.8 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Karen Holtmaat, Nadia van der Spek, Judith J M Rijnhart, Birgit Lissenberg-Witte, William Breitbart, Pim Cuijpers, Irma M Verdonck-de Leeuw
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Abstract

Purpose: After meaning-centered group psychotherapy for cancer survivors (MCGP-CS), depressive symptoms tend to decrease. An enhanced sense of meaning may play a mediating role in this decrease. The aim of this study was to assess whether personal meaning mediates the relationship between MCGP-CS and depressive symptoms.

Methods: Cancer survivors (n = 114) were randomly allocated to MCGP-CS or care as usual (CAU). The assessments were scheduled at baseline, postintervention, and at 3- and 6-month follow-up. Mediation models were estimated based on structural equation modeling. We computed the indirect effect of MCGP-CS on depressive symptoms at the 3-month follow-up through personal meaning, and other meaning-related mediators, measured postintervention.

Results: A small but significant indirect effect of MCGP-CS on depressive symptoms at the 3-month follow-up was found through personal meaning postintervention (b = - 0.29, 95% bootstrap CI (- 0.63, - 0.03)). There were no significant indirect effects through the other meaning-related factors.

Conclusions: This study tentatively supports the MCGP-CS working model in that an enhanced sense of meaning as a result of MCGP-CS mediates a reduction in depressive symptoms. Personal meaning mediated a small effect of MCGP-CS on depressive symptoms. The longitudinal mediating effect of personal meaning occurred within a time period of 3 months after MCGP-CS.

Relevance: MCGP-CS is a psychological intervention that supports cancer survivors in regaining or enhancing a sense of meaning in their lives. This enhanced sense of meaning is a protective factor against depressive symptoms.

Trial registration: The RCT was registered in the Netherlands Trial Register (number NTR3571/NL3421) on August 10, 2012.

以意义为中心的团体心理治疗后,意义的增强是否会促进癌症幸存者抑郁症状的减轻?随机对照试验中的中介分析。
目的:对癌症幸存者进行以意义为中心的团体心理治疗(MCGP-CS)后,抑郁症状往往会减轻。意义感的增强可能会对抑郁症状的减轻起到中介作用。本研究的目的是评估个人意义是否能调节MCGP-CS与抑郁症状之间的关系:癌症幸存者(n = 114)被随机分配到 MCGP-CS 或常规护理(CAU)中。评估安排在基线、干预后、3个月和6个月随访时进行。我们根据结构方程模型对中介模型进行了估算。我们通过干预后测量的个人意义和其他与意义相关的中介因素,计算了 MCGP-CS 在 3 个月随访时对抑郁症状的间接影响:通过干预后的个人意义(b = - 0.29, 95% bootstrap CI (- 0.63, - 0.03)),我们发现 MCGP-CS 在 3 个月的随访中对抑郁症状的间接影响很小,但很明显。其他与意义相关的因素没有明显的间接影响:本研究初步支持 MCGP-CS 的工作模型,即 MCGP-CS 带来的意义感增强会促进抑郁症状的减轻。个人意义对 MCGP-CS 对抑郁症状的影响很小。个人意义的纵向中介效应发生在 MCGP-CS 结束后的 3 个月内:MCGP-CS是一种心理干预措施,可帮助癌症幸存者重新获得或增强生活意义感。这种意义感的增强是抑郁症状的保护因素:该RCT已于2012年8月10日在荷兰试验注册中心注册(编号为NTR3571/NL3421)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Supportive Care in Cancer
Supportive Care in Cancer 医学-康复医学
CiteScore
5.70
自引率
9.70%
发文量
751
审稿时长
3 months
期刊介绍: Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.
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