Nasim Badaghi, Linda Kwakkenbos, Judith Prins, Rogier Donders, Saskia Kelders, Anne Speckens
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The primary outcome analyzed in the intention-to-treat (ITT) population was psychological distress (Hospital Anxiety and Depression Scale) at post-treatment.</p><p><strong>Results: </strong>In total, 186 participants were randomized to group-blended eMBCT (N = 57), individual-unguided eMBCT (N = 75), or CAU (N = 54). Most participants were female (81%) with breast cancer (49%), and treated with curative intent (76%). In ITT analyses, group-blended eMBCT participants reported significantly lower levels of psychological distress at post-treatment (Cohen's d = 0.38) and follow-up (Cohen's d = 0.64) than those receiving CAU, while individual-unguided eMBCT participants only had significantly less psychological distress at follow-up (Cohen's d = 0.48). Additionally, participants in group-blended eMBCT had less rumination and greater mindfulness, decentering, and self-compassion than those in CAU at follow-up. 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引用次数: 0
摘要
目的：在线正念认知疗法（eMBCT）可以减少癌症患者的心理困扰，但其依从性和可扩展性有待提高。通过共同创造，我们开发了两种eMBCT格式：群体混合和个人非导向。该试验比较了两种eMBCT与常规护理（CAU）对癌症患者心理困扰和其他心理健康结果的影响。方法：在这项平行的三臂随机对照试验中，癌症患者被随机分配到组混合eMBCT、个体非引导eMBCT或CAU。参与者完成了基线、治疗中期、治疗后和3个月的随访评估。在意向治疗（ITT）人群中分析的主要结局是治疗后的心理困扰（医院焦虑和抑郁量表）。结果：共有186名参与者被随机分配到组混合eMBCT (N = 57)，个体非引导eMBCT （N = 75）或CAU （N = 54）。大多数参与者是女性（81%），患有乳腺癌（49%），并有治疗意图（76%）。在ITT分析中，分组混合eMBCT参与者在治疗后（Cohen’s d = 0.38）和随访（Cohen’s d = 0.64）报告的心理困扰水平明显低于接受CAU的参与者，而个体未指导的eMBCT参与者在随访时的心理困扰水平仅显着降低（Cohen’s d = 0.48）。此外，小组混合eMBCT的参与者在随访时比CAU的参与者有更少的反刍和更大的正念、去中心化和自我同情。在治疗后和随访中，个体无指导eMBCT的参与者比CAU的参与者有更大的去中心化，在随访中，反刍更少，正念技能比CAU高。结论：与CAU相比，两种eMBCT条件都能有效减少心理困扰，可能是一种可获得的、潜在的低成本干预措施，以减少癌症患者的痛苦。试验注册：荷兰注册CCMO， nl7317.091.20；clinicaltrials.gov NCT05336916。
Randomized Controlled Trial of Group-Blended and Individual-Unguided Online Mindfulness-Based Cognitive Therapy to Reduce Psychological Distress in People With Cancer.
Objective: Online mindfulness-based cognitive therapy (eMBCT) can reduce psychological distress in people with cancer, but adherence and scalability could be improved. Through co-creation, we developed two eMBCT formats: group-blended and individual-unguided. This trial compared the effects of the two eMBCT to care as usual (CAU) on psychological distress and other mental health outcomes in people with cancer.
Methods: In this parallel, three-armed randomized controlled trial, people with cancer were randomly allocated to group-blended eMBCT, individual-unguided eMBCT, or CAU. Participants completed baseline, mid-treatment, post-treatment, and 3 months follow-up assessments. The primary outcome analyzed in the intention-to-treat (ITT) population was psychological distress (Hospital Anxiety and Depression Scale) at post-treatment.
Results: In total, 186 participants were randomized to group-blended eMBCT (N = 57), individual-unguided eMBCT (N = 75), or CAU (N = 54). Most participants were female (81%) with breast cancer (49%), and treated with curative intent (76%). In ITT analyses, group-blended eMBCT participants reported significantly lower levels of psychological distress at post-treatment (Cohen's d = 0.38) and follow-up (Cohen's d = 0.64) than those receiving CAU, while individual-unguided eMBCT participants only had significantly less psychological distress at follow-up (Cohen's d = 0.48). Additionally, participants in group-blended eMBCT had less rumination and greater mindfulness, decentering, and self-compassion than those in CAU at follow-up. Participants in individual-unguided eMBCT had greater decentering than those in CAU at post-treatment and follow-up, and less rumination and greater mindfulness skills than CAU at follow-up.
Conclusions: Compared to CAU, both eMBCT conditions were effective in reducing psychological distress and could be an accessible, and potentially low-cost intervention to reduce distress in people with cancer.
期刊介绍：
Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology.
This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues.
Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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