Cognitive behavioral digital therapeutic effects on distress and quality of life in patients with cancer: National randomized controlled trial.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of consulting and clinical psychology Pub Date : 2024-11-01 DOI:10.1037/ccp0000911

Chloe J Taub, Sean R Zion, Molly Ream, Allison Ramiller, Lauren C Heathcote, Geoff Eich, Meridithe Mendelsohn, Justin Birckbichler, Patricia A Ganz, David Cella, Frank J Penedo, Michael Antoni, Dianne M Shumay

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引用次数: 0

Abstract

Objective: Cancer-specific psychological interventions like cognitive behavioral stress management (CBSM) demonstrate distress (e.g., anxiety/depression) and quality of life (QoL) benefits. Digital formats can expand access.

Method: Patients (80.6% female; 76.5% White; 25-80 years) with Stage I-III cancer and elevated anxiety within 6 months of treatment (surgery/chemotherapy/radiation/immunotherapy) receipt were randomized 1:1 to a 10-module CBSM or health education control digital app and completed questionnaires at Weeks 0, 4, 8, 12. Primary outcomes of greater group-level anxiety (PROMIS-A) and depression symptom (PROMIS-D) reductions for CBSM were met and published; this secondary report evaluates individual-level response results for these outcomes and outcomes beyond anxiety and depression. Chi-square tests compared responder proportions using PROMIS-A/PROMIS-D symptom categories and two levels (≥5/≥7.5) of T-score point reductions. Changes across conditions over time for stress (Perceived Stress Scale), cancer-specific distress (Impact of Event Scale-Intrusions), and QoL (Functional Assessment of Cancer Therapy-General) were analyzed using repeated measures linear mixed-effects modeling (N = 449). Patient Global Impression of Change-Well-being was also examined.

Results: At Week 12, a greater proportion of CBSM (vs. control) participants reported normal-to-mild (vs. moderate-to-severe) PROMIS-A and PROMIS-D, and a greater proportion of CBSM participants at Week 8 or 12 had a ≥7.5 T-score reduction in PROMIS-A and a ≥5 T-score reduction in PROMIS-D (ps < .05). CBSM participants (vs. control) showed significantly greater reductions in Perceived Stress Scale and Impact of Event Scale-Intrusions and increases in Patient Global Impression of Change-Well-being and Functional Assessment of Cancer Therapy emotional and physical well-being (ps < .05), but not functional or social/family well-being.

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认知行为数字治疗对癌症患者痛苦和生活质量的影响：国家随机对照试验。

目的：认知行为压力管理（CBSM）等癌症特异性心理干预显示了痛苦（如焦虑/抑郁）和生活质量（QoL）的益处。数字格式可以扩大访问范围。方法：患者中女性占80.6%；76.5%的白人;25-80岁)的I-III期癌症患者在治疗（手术/化疗/放疗/免疫治疗）6个月内焦虑升高，接受1:1的随机分配到10个模块的CBSM或健康教育控制数字应用程序，并在第0,4,8,12周完成问卷调查。主要结局是CBSM患者群体水平焦虑（promise - a）和抑郁症状（promise - d）的减少得到满足并发表；该次要报告评估了这些结果和焦虑和抑郁之外的结果的个体水平反应结果。卡方检验使用promise - a / promise - d症状类别和两个水平（≥5/≥7.5）的t评分降低来比较应答者比例。使用重复测量线性混合效应模型（N = 449）分析了压力（感知压力量表）、癌症特异性痛苦（事件影响量表-入侵）和QoL（癌症治疗功能评估）随时间的变化。患者对改变-幸福的整体印象也被检查。结果：在第12周，更大比例的CBSM参与者（与对照组相比）报告了正常到轻度（相对于中度到重度）promise - a和promise - d，并且更大比例的CBSM参与者在第8周或第12周的promise - at评分降低≥7.5，promise - d t评分降低≥5 （ps < 0.05）。CBSM参与者（与对照组相比）在感知压力量表和事件量表-入侵的影响方面显著降低，在患者对变化-幸福感的整体印象和癌症治疗的情绪和身体健康的功能评估方面显著增加（ps < 0.05），但在功能或社会/家庭幸福感方面没有显著增加。结论：数字化CBSM有利于患者的痛苦和生活质量。（PsycInfo Database Record (c) 2024 APA，版权所有）。

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

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.