{"title":"行为激活在减少非小细胞肺癌患者癌症复发恐惧中的疗效：一项随机对照试验。","authors":"Han Ge, Anlong Li, Runze Huang, Chen Gan, Yingxue Jia, Jiaying Chai, Lijun Liu, Xinyi Zheng, Jian Xu, Mingjun Zhang, Huaidong Cheng","doi":"10.62347/ZSKM4538","DOIUrl":null,"url":null,"abstract":"<p><p>Fear of cancer recurrence (FCR) is a significant risk factor affecting treatment outcomes and prognosis in non-small cell lung cancer (NSCLC) survivors. Behavioral activation (BA), a structured therapeutic approach based on cognitive-behavioral therapy (CBT) principles, has demonstrated efficacy in alleviating psychological distress among cancer patients. This study aims to investigate the effect of BA on FCR in patients with NSCLC and explore the underlying mechanisms. A total of 82 eligible patients were randomly assigned to either the intervention group (BA) (n = 41) or the usual care group (CAU) (n = 41). Assessments were conducted at baseline (T0), week 4 (T1), and week 8 (T2) using the Cancer Recurrence Fear Scale-Brief Form (FCRI-SF), the Hospital Anxiety and Depression Scale (HADS), the Brief Resilient Coping Scale (BRCS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) version 3.0. Negative emotions (depression and anxiety), as well as resilient coping, were identified as potential mediators. The intervention effect and its potential mediating effects were analyzed using generalized estimating equations (GEE). GEE analysis revealed significantly lower FCR scores in the BA group at weeks 4 and 8 (Group*T1: Wald X<sup>2</sup> = 25.79, P < 0.001; Group*T2: Wald X<sup>2</sup> = 59.59, P < 0.001). Depression and anxiety scores decreased over time in the BA group and remained consistently lower than those in the usual care group (depression: Group*T1 Wald X<sup>2</sup> = 34.67, P < 0.001; Group*T2 Wald X<sup>2</sup> = 56.05, P < 0.001; anxiety: Group*T1 Wald X<sup>2</sup> = 36.22, P < 0.001; Group*T2 Wald X<sup>2</sup> = 64.85, P < 0.001). Scores for resilient coping and quality of life increased over time in the BA group and were significantly higher than those in the usual care group (resilient coping: Group*T1 Wald X<sup>2</sup> = 19.49, P < 0.001; Group*T2 Wald X<sup>2</sup> = 66.19, P < 0.001; quality of life: Group*T1 Wald X<sup>2</sup> = 19.86, P < 0.001; Group*T2 Wald X<sup>2</sup> = 64.46, P < 0.001). Furthermore, negative emotions (depression and anxiety), as well as resilient coping, were found to mediate the effect of BA on changes in FCR. The BA intervention can alleviate FCR symptoms and improve the quality of life in NSCLC patients by reducing negative emotions (depression and anxiety) and enhancing resilient coping.</p>","PeriodicalId":7437,"journal":{"name":"American journal of cancer research","volume":"15 4","pages":"1806-1819"},"PeriodicalIF":3.6000,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070099/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy of behavioral activation in reducing fear of cancer recurrence in non-small cell lung cancer patients: a randomized controlled trial.\",\"authors\":\"Han Ge, Anlong Li, Runze Huang, Chen Gan, Yingxue Jia, Jiaying Chai, Lijun Liu, Xinyi Zheng, Jian Xu, Mingjun Zhang, Huaidong Cheng\",\"doi\":\"10.62347/ZSKM4538\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Fear of cancer recurrence (FCR) is a significant risk factor affecting treatment outcomes and prognosis in non-small cell lung cancer (NSCLC) survivors. Behavioral activation (BA), a structured therapeutic approach based on cognitive-behavioral therapy (CBT) principles, has demonstrated efficacy in alleviating psychological distress among cancer patients. This study aims to investigate the effect of BA on FCR in patients with NSCLC and explore the underlying mechanisms. A total of 82 eligible patients were randomly assigned to either the intervention group (BA) (n = 41) or the usual care group (CAU) (n = 41). Assessments were conducted at baseline (T0), week 4 (T1), and week 8 (T2) using the Cancer Recurrence Fear Scale-Brief Form (FCRI-SF), the Hospital Anxiety and Depression Scale (HADS), the Brief Resilient Coping Scale (BRCS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) version 3.0. Negative emotions (depression and anxiety), as well as resilient coping, were identified as potential mediators. The intervention effect and its potential mediating effects were analyzed using generalized estimating equations (GEE). GEE analysis revealed significantly lower FCR scores in the BA group at weeks 4 and 8 (Group*T1: Wald X<sup>2</sup> = 25.79, P < 0.001; Group*T2: Wald X<sup>2</sup> = 59.59, P < 0.001). Depression and anxiety scores decreased over time in the BA group and remained consistently lower than those in the usual care group (depression: Group*T1 Wald X<sup>2</sup> = 34.67, P < 0.001; Group*T2 Wald X<sup>2</sup> = 56.05, P < 0.001; anxiety: Group*T1 Wald X<sup>2</sup> = 36.22, P < 0.001; Group*T2 Wald X<sup>2</sup> = 64.85, P < 0.001). Scores for resilient coping and quality of life increased over time in the BA group and were significantly higher than those in the usual care group (resilient coping: Group*T1 Wald X<sup>2</sup> = 19.49, P < 0.001; Group*T2 Wald X<sup>2</sup> = 66.19, P < 0.001; quality of life: Group*T1 Wald X<sup>2</sup> = 19.86, P < 0.001; Group*T2 Wald X<sup>2</sup> = 64.46, P < 0.001). Furthermore, negative emotions (depression and anxiety), as well as resilient coping, were found to mediate the effect of BA on changes in FCR. The BA intervention can alleviate FCR symptoms and improve the quality of life in NSCLC patients by reducing negative emotions (depression and anxiety) and enhancing resilient coping.</p>\",\"PeriodicalId\":7437,\"journal\":{\"name\":\"American journal of cancer research\",\"volume\":\"15 4\",\"pages\":\"1806-1819\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-04-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070099/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of cancer research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.62347/ZSKM4538\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of cancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.62347/ZSKM4538","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
对癌症复发的恐惧（FCR）是影响非小细胞肺癌（NSCLC）幸存者治疗结果和预后的重要危险因素。行为激活（BA）是一种基于认知行为治疗（CBT）原理的结构化治疗方法，在缓解癌症患者的心理困扰方面已被证明有效。本研究旨在探讨BA对NSCLC患者FCR的影响，并探讨其潜在机制。共有82例符合条件的患者被随机分配到干预组（BA） （n = 41）或常规护理组（CAU） （n = 41）。在基线（T0）、第4周（T1）和第8周（T2）使用癌症复发恐惧量表-简易表格（FCRI-SF）、医院焦虑和抑郁量表（HADS）、简易弹性应对量表（BRCS）和欧洲癌症研究和治疗组织生活质量问卷C30 (EORTC QLQ-C30) 3.0版本进行评估。消极情绪（抑郁和焦虑），以及弹性应对，被认为是潜在的中介。采用广义估计方程分析了干预效应及其潜在的中介效应。GEE分析显示，BA组在第4周和第8周的FCR评分显著低于对照组(组*T1: Wald X2 = 25.79, P < 0.001；T2组：Wald X2 = 59.59, P < 0.001)。BA组抑郁和焦虑评分随时间推移而下降，且始终低于常规护理组(抑郁：组*T1 Wald X2 = 34.67, P < 0.001；组*T2 Wald X2 = 56.05, P < 0.001；焦虑：组*T1 Wald X2 = 36.22, P < 0.001；组*T2 Wald X2 = 64.85, P < 0.001)。BA组弹性应对和生活质量得分随时间增加，显著高于常规护理组(弹性应对：组*T1 Wald X2 = 19.49, P < 0.001；组*T2 Wald X2 = 66.19, P < 0.001；生存质量：组*T1 Wald X2 = 19.86, P < 0.001；组*T2 Wald X2 = 64.46, P < 0.001)。此外，负面情绪（抑郁和焦虑）以及弹性应对在BA对FCR变化的影响中起中介作用。BA干预可以通过减少负面情绪（抑郁和焦虑）和增强弹性应对来缓解FCR症状，改善NSCLC患者的生活质量。
Efficacy of behavioral activation in reducing fear of cancer recurrence in non-small cell lung cancer patients: a randomized controlled trial.
Fear of cancer recurrence (FCR) is a significant risk factor affecting treatment outcomes and prognosis in non-small cell lung cancer (NSCLC) survivors. Behavioral activation (BA), a structured therapeutic approach based on cognitive-behavioral therapy (CBT) principles, has demonstrated efficacy in alleviating psychological distress among cancer patients. This study aims to investigate the effect of BA on FCR in patients with NSCLC and explore the underlying mechanisms. A total of 82 eligible patients were randomly assigned to either the intervention group (BA) (n = 41) or the usual care group (CAU) (n = 41). Assessments were conducted at baseline (T0), week 4 (T1), and week 8 (T2) using the Cancer Recurrence Fear Scale-Brief Form (FCRI-SF), the Hospital Anxiety and Depression Scale (HADS), the Brief Resilient Coping Scale (BRCS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) version 3.0. Negative emotions (depression and anxiety), as well as resilient coping, were identified as potential mediators. The intervention effect and its potential mediating effects were analyzed using generalized estimating equations (GEE). GEE analysis revealed significantly lower FCR scores in the BA group at weeks 4 and 8 (Group*T1: Wald X2 = 25.79, P < 0.001; Group*T2: Wald X2 = 59.59, P < 0.001). Depression and anxiety scores decreased over time in the BA group and remained consistently lower than those in the usual care group (depression: Group*T1 Wald X2 = 34.67, P < 0.001; Group*T2 Wald X2 = 56.05, P < 0.001; anxiety: Group*T1 Wald X2 = 36.22, P < 0.001; Group*T2 Wald X2 = 64.85, P < 0.001). Scores for resilient coping and quality of life increased over time in the BA group and were significantly higher than those in the usual care group (resilient coping: Group*T1 Wald X2 = 19.49, P < 0.001; Group*T2 Wald X2 = 66.19, P < 0.001; quality of life: Group*T1 Wald X2 = 19.86, P < 0.001; Group*T2 Wald X2 = 64.46, P < 0.001). Furthermore, negative emotions (depression and anxiety), as well as resilient coping, were found to mediate the effect of BA on changes in FCR. The BA intervention can alleviate FCR symptoms and improve the quality of life in NSCLC patients by reducing negative emotions (depression and anxiety) and enhancing resilient coping.
期刊介绍：
The American Journal of Cancer Research (AJCR) (ISSN 2156-6976), is an independent open access, online only journal to facilitate rapid dissemination of novel discoveries in basic science and treatment of cancer. It was founded by a group of scientists for cancer research and clinical academic oncologists from around the world, who are devoted to the promotion and advancement of our understanding of the cancer and its treatment. The scope of AJCR is intended to encompass that of multi-disciplinary researchers from any scientific discipline where the primary focus of the research is to increase and integrate knowledge about etiology and molecular mechanisms of carcinogenesis with the ultimate aim of advancing the cure and prevention of this increasingly devastating disease. To achieve these aims AJCR will publish review articles, original articles and new techniques in cancer research and therapy. It will also publish hypothesis, case reports and letter to the editor. Unlike most other open access online journals, AJCR will keep most of the traditional features of paper print that we are all familiar with, such as continuous volume, issue numbers, as well as continuous page numbers to retain our comfortable familiarity towards an academic journal.
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