Catherine E Mosher, Shieun Lee, Elizabeth L Addington, Seho Park, Ashley B Lewson, Stella Snyder, Adam T Hirsh, Jonathan B Bricker, Kathy D Miller, Tarah J Ballinger, Bryan P Schneider, Anna Maria Storniolo, Erin V Newton, Victoria L Champion, Shelley A Johns
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Patients completed a baseline assessment that included self-report measures of fatigue interference with activities, mood, and cognition (primary outcome) and sleep interference with functioning, engagement in daily activities, and quality of life (QOL; secondary outcomes). Then patients were randomly assigned to six weekly telephone-delivered sessions of either ACT (n = 116) or education/support (n = 120). Follow-up assessments occurred at 2 weeks, 3 months, and 6 months postintervention (means, 9.69, 20.51, and 33.59 weeks postbaseline, respectively).</p><p><strong>Results: </strong>Linear mixed model analyses showed that compared with patients in the education/support condition, patients in the ACT condition reported significantly less fatigue interference (<i>P</i> = .018). These results were significant at 2 weeks and 6 months postintervention. ACT's effect on sleep interference was not statistically significant after the Sidak adjustment for multiple comparisons (<i>P</i> = .037). ACT patients showed a steady decline in sleep interference, a trend that was not found for education/support patients. Engagement in daily activities and QOL did not significantly differ between study groups, except for functional QOL (<i>P</i> = .006). Compared with education/support patients, ACT patients showed significantly better functional QOL at 2 weeks and 6 months postintervention.</p><p><strong>Conclusion: </strong>Results suggest that a brief, telephone-delivered ACT intervention can reduce fatigue interference with functioning in patients with MBC.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"662-671"},"PeriodicalIF":42.1000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Randomized Controlled Trial of Acceptance and Commitment Therapy for Fatigue Interference With Functioning in Metastatic Breast Cancer.\",\"authors\":\"Catherine E Mosher, Shieun Lee, Elizabeth L Addington, Seho Park, Ashley B Lewson, Stella Snyder, Adam T Hirsh, Jonathan B Bricker, Kathy D Miller, Tarah J Ballinger, Bryan P Schneider, Anna Maria Storniolo, Erin V Newton, Victoria L Champion, Shelley A Johns\",\"doi\":\"10.1200/JCO.24.00965\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Fatigue is a highly prevalent and disabling symptom for patients with metastatic breast cancer (MBC). 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引用次数: 0
摘要
目的：疲劳是转移性乳腺癌（MBC）患者普遍存在的一种致残症状。目前还缺乏针对晚期癌症患者疲劳管理的循证干预措施。这项 II 期随机对照试验测试了接纳与承诺疗法（ACT）对 MBC 患者疲劳干扰功能的影响：符合条件的患者为患有中度至重度疲劳干扰的 IV 期乳腺癌女性患者。患者完成基线评估，包括疲劳对活动、情绪和认知的干扰（主要结果）以及睡眠对功能、日常活动参与和生活质量的干扰（次要结果）的自我报告测量。然后，患者被随机分配到每周六次的通过电话提供的 ACT（116 人）或教育/支持（120 人）疗程中。干预后 2 周、3 个月和 6 个月进行随访评估（平均分别为基线后 9.69 周、20.51 周和 33.59 周）：线性混合模型分析显示，与教育/支持条件下的患者相比，ACT 条件下的患者报告的疲劳干扰明显减少（P = .018）。这些结果在干预后 2 周和 6 个月仍有意义。经 Sidak 多重比较调整后，ACT 对睡眠干扰的影响无统计学意义（P = .037）。ACT 患者的睡眠干扰稳步下降，而教育/支持患者却没有这种趋势。除功能性 QOL 外（P = .006），参与日常活动和 QOL 在研究组之间没有显著差异。与教育/支持患者相比，ACT 患者在干预后 2 周和 6 个月的功能 QOL 明显更好：结果表明，通过电话进行简短的 ACT 干预可以减少 MBC 患者因疲劳而产生的功能障碍。
Randomized Controlled Trial of Acceptance and Commitment Therapy for Fatigue Interference With Functioning in Metastatic Breast Cancer.
Purpose: Fatigue is a highly prevalent and disabling symptom for patients with metastatic breast cancer (MBC). Evidence-based interventions for managing fatigue in advanced cancer populations are lacking. This phase II randomized controlled trial tested the effect of acceptance and commitment therapy (ACT) on fatigue interference with functioning in patients with MBC.
Methods: Eligible patients were women with stage IV breast cancer who had moderate to severe fatigue interference. Patients completed a baseline assessment that included self-report measures of fatigue interference with activities, mood, and cognition (primary outcome) and sleep interference with functioning, engagement in daily activities, and quality of life (QOL; secondary outcomes). Then patients were randomly assigned to six weekly telephone-delivered sessions of either ACT (n = 116) or education/support (n = 120). Follow-up assessments occurred at 2 weeks, 3 months, and 6 months postintervention (means, 9.69, 20.51, and 33.59 weeks postbaseline, respectively).
Results: Linear mixed model analyses showed that compared with patients in the education/support condition, patients in the ACT condition reported significantly less fatigue interference (P = .018). These results were significant at 2 weeks and 6 months postintervention. ACT's effect on sleep interference was not statistically significant after the Sidak adjustment for multiple comparisons (P = .037). ACT patients showed a steady decline in sleep interference, a trend that was not found for education/support patients. Engagement in daily activities and QOL did not significantly differ between study groups, except for functional QOL (P = .006). Compared with education/support patients, ACT patients showed significantly better functional QOL at 2 weeks and 6 months postintervention.
Conclusion: Results suggest that a brief, telephone-delivered ACT intervention can reduce fatigue interference with functioning in patients with MBC.
期刊介绍：
The Journal of Clinical Oncology serves its readers as the single most credible, authoritative resource for disseminating significant clinical oncology research. In print and in electronic format, JCO strives to publish the highest quality articles dedicated to clinical research. Original Reports remain the focus of JCO, but this scientific communication is enhanced by appropriately selected Editorials, Commentaries, Reviews, and other work that relate to the care of patients with cancer.
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