Huiyuan Li , Cho Lee Wong , Xiaohuan Jin , Yuen Yu Chong , Marques Shek Nam Ng
{"title":"基于接纳与承诺疗法的干预对晚期肺癌患者疲劳干扰和健康相关生活质量的影响:随机对照试验","authors":"Huiyuan Li , Cho Lee Wong , Xiaohuan Jin , Yuen Yu Chong , Marques Shek Nam Ng","doi":"10.1016/j.jcbs.2024.100758","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Cancer-related fatigue is common in patients with advanced lung cancer, persistently interfering with their health-related quality of life. Acceptance and Commitment Therapy (ACT) may effectively reduce fatigue interference and improve health-related quality of life in the advanced lung cancer population. This study aimed to evaluate the effects of an ACT-based intervention on fatigue interference and health-related quality of life in patients with advanced lung cancer.</p></div><div><h3>Methods</h3><p>An assessor-blinded, two-arm randomised controlled trial with 160 patients with advanced lung cancer was conducted. Participants were randomly allocated into either a four-week ACT-based intervention group (n = 80) or usual care control group (n = 80). The intervention consisted of a face-to-face session and three video-conferencing-based sessions and was delivered on an individual basis. The primary outcomes were fatigue interference and health-related quality of life. The secondary outcomes included cancer-related fatigue, depression and anxiety, cancer-specific distress, and activity level. Changes in psychological flexibility (PF), experiential avoidance, and cognitive fusion were also evaluated. Outcomes were measured at baselines (T0), one-week post-intervention (T1), and 3-month follow-up (T2). The intervention effects were assessed using generalised estimating equation models.</p></div><div><h3>Results</h3><p>Compared with the control group, the intervention group demonstrated significant improvements in fatigue interference (T1: <em>β</em> = −0.50, <em>p</em> < 0.001; T2: <em>β</em> = −0.16, <em>p</em> = 0.007), health-related quality of life (T1: <em>β</em> = 16.01, <em>p</em> < 0.001; T2: <em>β</em> = 11.21, <em>p</em> < 0.001), depression (T1: <em>β</em> = −0.32, <em>p</em> < 0.001) and anxiety (T1: <em>β</em> = −0.20, <em>p</em> < 0.001), cancer-specific distress (T1: <em>β</em> = −7.37, <em>p</em> < 0.001; T2: <em>β</em> = −8.00, <em>p</em> < 0.001), activity level (intensity, T1: <em>β</em> = 3.24, <em>p</em> = 0.004; T2: <em>β</em> = 2.61, <em>p</em> = 0.020; frequency, T1: <em>β</em> = 2.44, <em>p</em> < 0.001; T2: <em>β</em> = 1.96, <em>p</em> < 0.001; duration, T1: <em>β</em> = 1.36, <em>p</em> < 0.001), PF (T1: <em>β</em> = 5.54, <em>p</em> < 0.001; T2: <em>β</em> = 8.63, <em>p</em> < 0.001), experiential avoidance (T1: <em>β</em> = −7.70, <em>p</em> < 0.001; T2: <em>β</em> = −10.07, <em>p</em> < 0.001), and cognitive fusion (T2: <em>β</em> = −3.31, <em>p</em> = 0.007). The changes in experiential avoidance at one-week post-intervention mediated the effects of ACT on reducing cancer-specific distress (<em>β</em> = −7.40, <em>p</em> < 0.001; <em>β</em> = −3.68, 95%CI, −5.77 to −1.58) and promoting HRQoL (<em>β</em> = 11.15, <em>p</em> < 0.001; <em>β</em> = 5.49, 95%CI, 3.09 to 8.31) at three-month follow-up. The changes in PF at one-week post-intervention mediated the effect of ACT on HRQoL (<em>β</em> = 11.15, <em>p</em> < 0.001; <em>β</em> = 2.25, 95%CI, 0.66 to 4.19) at three-month follow-up.</p></div><div><h3>Conclusions</h3><p>ACT-based intervention can effectively reduce fatigue interference and improve health-related quality of life in patients with advanced lung cancer. The intervention can be integrated into palliative care within the cancer system to contribute to the well-being of patients with advanced cancer.</p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"32 ","pages":"Article 100758"},"PeriodicalIF":3.4000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of acceptance and commitment therapy-based intervention on fatigue interference and health-related quality of life in patients with advanced lung cancer: A randomised controlled trial\",\"authors\":\"Huiyuan Li , Cho Lee Wong , Xiaohuan Jin , Yuen Yu Chong , Marques Shek Nam Ng\",\"doi\":\"10.1016/j.jcbs.2024.100758\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Cancer-related fatigue is common in patients with advanced lung cancer, persistently interfering with their health-related quality of life. Acceptance and Commitment Therapy (ACT) may effectively reduce fatigue interference and improve health-related quality of life in the advanced lung cancer population. This study aimed to evaluate the effects of an ACT-based intervention on fatigue interference and health-related quality of life in patients with advanced lung cancer.</p></div><div><h3>Methods</h3><p>An assessor-blinded, two-arm randomised controlled trial with 160 patients with advanced lung cancer was conducted. Participants were randomly allocated into either a four-week ACT-based intervention group (n = 80) or usual care control group (n = 80). The intervention consisted of a face-to-face session and three video-conferencing-based sessions and was delivered on an individual basis. The primary outcomes were fatigue interference and health-related quality of life. The secondary outcomes included cancer-related fatigue, depression and anxiety, cancer-specific distress, and activity level. Changes in psychological flexibility (PF), experiential avoidance, and cognitive fusion were also evaluated. Outcomes were measured at baselines (T0), one-week post-intervention (T1), and 3-month follow-up (T2). The intervention effects were assessed using generalised estimating equation models.</p></div><div><h3>Results</h3><p>Compared with the control group, the intervention group demonstrated significant improvements in fatigue interference (T1: <em>β</em> = −0.50, <em>p</em> < 0.001; T2: <em>β</em> = −0.16, <em>p</em> = 0.007), health-related quality of life (T1: <em>β</em> = 16.01, <em>p</em> < 0.001; T2: <em>β</em> = 11.21, <em>p</em> < 0.001), depression (T1: <em>β</em> = −0.32, <em>p</em> < 0.001) and anxiety (T1: <em>β</em> = −0.20, <em>p</em> < 0.001), cancer-specific distress (T1: <em>β</em> = −7.37, <em>p</em> < 0.001; T2: <em>β</em> = −8.00, <em>p</em> < 0.001), activity level (intensity, T1: <em>β</em> = 3.24, <em>p</em> = 0.004; T2: <em>β</em> = 2.61, <em>p</em> = 0.020; frequency, T1: <em>β</em> = 2.44, <em>p</em> < 0.001; T2: <em>β</em> = 1.96, <em>p</em> < 0.001; duration, T1: <em>β</em> = 1.36, <em>p</em> < 0.001), PF (T1: <em>β</em> = 5.54, <em>p</em> < 0.001; T2: <em>β</em> = 8.63, <em>p</em> < 0.001), experiential avoidance (T1: <em>β</em> = −7.70, <em>p</em> < 0.001; T2: <em>β</em> = −10.07, <em>p</em> < 0.001), and cognitive fusion (T2: <em>β</em> = −3.31, <em>p</em> = 0.007). The changes in experiential avoidance at one-week post-intervention mediated the effects of ACT on reducing cancer-specific distress (<em>β</em> = −7.40, <em>p</em> < 0.001; <em>β</em> = −3.68, 95%CI, −5.77 to −1.58) and promoting HRQoL (<em>β</em> = 11.15, <em>p</em> < 0.001; <em>β</em> = 5.49, 95%CI, 3.09 to 8.31) at three-month follow-up. The changes in PF at one-week post-intervention mediated the effect of ACT on HRQoL (<em>β</em> = 11.15, <em>p</em> < 0.001; <em>β</em> = 2.25, 95%CI, 0.66 to 4.19) at three-month follow-up.</p></div><div><h3>Conclusions</h3><p>ACT-based intervention can effectively reduce fatigue interference and improve health-related quality of life in patients with advanced lung cancer. The intervention can be integrated into palliative care within the cancer system to contribute to the well-being of patients with advanced cancer.</p></div>\",\"PeriodicalId\":47544,\"journal\":{\"name\":\"Journal of Contextual Behavioral Science\",\"volume\":\"32 \",\"pages\":\"Article 100758\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Contextual Behavioral Science\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2212144724000383\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Contextual Behavioral Science","FirstCategoryId":"102","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212144724000383","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
Effects of acceptance and commitment therapy-based intervention on fatigue interference and health-related quality of life in patients with advanced lung cancer: A randomised controlled trial
Background
Cancer-related fatigue is common in patients with advanced lung cancer, persistently interfering with their health-related quality of life. Acceptance and Commitment Therapy (ACT) may effectively reduce fatigue interference and improve health-related quality of life in the advanced lung cancer population. This study aimed to evaluate the effects of an ACT-based intervention on fatigue interference and health-related quality of life in patients with advanced lung cancer.
Methods
An assessor-blinded, two-arm randomised controlled trial with 160 patients with advanced lung cancer was conducted. Participants were randomly allocated into either a four-week ACT-based intervention group (n = 80) or usual care control group (n = 80). The intervention consisted of a face-to-face session and three video-conferencing-based sessions and was delivered on an individual basis. The primary outcomes were fatigue interference and health-related quality of life. The secondary outcomes included cancer-related fatigue, depression and anxiety, cancer-specific distress, and activity level. Changes in psychological flexibility (PF), experiential avoidance, and cognitive fusion were also evaluated. Outcomes were measured at baselines (T0), one-week post-intervention (T1), and 3-month follow-up (T2). The intervention effects were assessed using generalised estimating equation models.
Results
Compared with the control group, the intervention group demonstrated significant improvements in fatigue interference (T1: β = −0.50, p < 0.001; T2: β = −0.16, p = 0.007), health-related quality of life (T1: β = 16.01, p < 0.001; T2: β = 11.21, p < 0.001), depression (T1: β = −0.32, p < 0.001) and anxiety (T1: β = −0.20, p < 0.001), cancer-specific distress (T1: β = −7.37, p < 0.001; T2: β = −8.00, p < 0.001), activity level (intensity, T1: β = 3.24, p = 0.004; T2: β = 2.61, p = 0.020; frequency, T1: β = 2.44, p < 0.001; T2: β = 1.96, p < 0.001; duration, T1: β = 1.36, p < 0.001), PF (T1: β = 5.54, p < 0.001; T2: β = 8.63, p < 0.001), experiential avoidance (T1: β = −7.70, p < 0.001; T2: β = −10.07, p < 0.001), and cognitive fusion (T2: β = −3.31, p = 0.007). The changes in experiential avoidance at one-week post-intervention mediated the effects of ACT on reducing cancer-specific distress (β = −7.40, p < 0.001; β = −3.68, 95%CI, −5.77 to −1.58) and promoting HRQoL (β = 11.15, p < 0.001; β = 5.49, 95%CI, 3.09 to 8.31) at three-month follow-up. The changes in PF at one-week post-intervention mediated the effect of ACT on HRQoL (β = 11.15, p < 0.001; β = 2.25, 95%CI, 0.66 to 4.19) at three-month follow-up.
Conclusions
ACT-based intervention can effectively reduce fatigue interference and improve health-related quality of life in patients with advanced lung cancer. The intervention can be integrated into palliative care within the cancer system to contribute to the well-being of patients with advanced cancer.
期刊介绍:
The Journal of Contextual Behavioral Science is the official journal of the Association for Contextual Behavioral Science (ACBS).
Contextual Behavioral Science is a systematic and pragmatic approach to the understanding of behavior, the solution of human problems, and the promotion of human growth and development. Contextual Behavioral Science uses functional principles and theories to analyze and modify action embedded in its historical and situational context. The goal is to predict and influence behavior, with precision, scope, and depth, across all behavioral domains and all levels of analysis, so as to help create a behavioral science that is more adequate to the challenge of the human condition.