Effects of Web-Based Acceptance and Commitment Therapy on Health-Related Outcomes Among Patients With Lung Cancer: A Feasibility Randomized Controlled Trial.

IF 3.3 2区医学 Q2 ONCOLOGY Psycho‐Oncology Pub Date : 2024-12-01 DOI:10.1002/pon.70045

Yalin Zhang, Chunhua Liu, Xiaoli Chen, Yun Zhang, Yunhuan Li, Xiaolin Hu

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Abstract

Objective: To identify the feasibility, acceptability, and effectiveness of web-based acceptance and commitment therapy (ACT) on health-related outcomes in patients with lung cancer.

Methods: A feasibility, prospective, parallel, individual-based, assessor-blinded randomized controlled trial was designed. This study was conducted at a third-level hospital in Sichuan Province, China. A total of 101 participants were enrolled and randomly assigned to usual care group or 7-weekly web-based acceptance and commitment therapy group. The primary outcome was feasibility and acceptability of the intervention, and the secondary outcomes including quality of life, psychological flexibility, anxiety, depression, fatigue, and sleep disturbance. Generalized estimating equations were used to evaluate the group differences. All analyses followed the principle of intention-to-treat.

Results: Web-based ACT presented good feasibility and acceptability in this study, with an attrition rate of 13.86%, a median compliance rate of 71.43%, and a satisfaction rate of 65.9%. Compared with control group, participants in intervention group reported statistically significant increases in quality of life (MD = 15.10, 95% CI: [10.09, 20.11], d = 0.37), psychological flexibility (MD = -8.42, 95% CI: [-10.81, -6.03], d = -1.47), anxiety (MD = -1.27, 95% CI: [-2.50, -0.05], d = -0.44), depression (MD = -2.11, 95% CI: [-3.28, -0.95], d = -0.76), and sleep disturbance (MD = -1.85, 95% CI: [-3.10, -0.59], d = 0.13) at postintervention, however, the improvement in fatigue was not statistically significant (MD = -2.02, 95% CI: [-9.02, 4.98], d = -0.12).

Conclusions: Web-based ACT was an approach with good feasibility and acceptability, and it could effectively improve quality of life, psychological flexibility, anxiety, depression, and sleep disturbance in patients with lung cancer. In order to achieve better results, there is a need to design a more tailored intervention plan and a more operational platform.

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基于网络的接纳与承诺疗法对肺癌患者健康相关结果的影响：可行性随机对照试验》。

目的确定基于网络的接纳与承诺疗法（ACT）对肺癌患者健康相关结果的可行性、可接受性和有效性：设计了一项可行性、前瞻性、平行、基于个体、评估者盲法的随机对照试验。这项研究在中国四川省一家三级甲等医院进行。共有101名参与者被随机分配到常规治疗组或为期7周的基于网络的接纳与承诺治疗组。主要结果为干预的可行性和可接受性，次要结果包括生活质量、心理灵活性、焦虑、抑郁、疲劳和睡眠障碍。采用广义估计方程来评估组间差异。所有分析均遵循意向治疗原则：在这项研究中，基于网络的 ACT 具有良好的可行性和可接受性，自然减员率为 13.86%，依从率中位数为 71.43%，满意率为 65.9%。与对照组相比，干预组参与者的生活质量（MD = 15.10，95% CI：[10.09, 20.11]，d = 0.37）、心理灵活性（MD = -8.42，95% CI：[-10.81, -6.03]，d =-1.47）、焦虑（MD = -1.27，95% CI：[-2.50, -0.05]，d = -0.44）、抑郁（MD = -2.11，95% CI：[-3.28，-0.95]，d = -0.76）和睡眠障碍（MD =-1.85，95% CI：[-3.10，-0.59]，d = 0.13），然而，在干预后，疲劳的改善并无统计学意义（MD = -2.02，95% CI：[-9.02，4.98]，d = -0.12）：基于网络的 ACT 是一种具有良好可行性和可接受性的方法，能有效改善肺癌患者的生活质量、心理灵活性、焦虑、抑郁和睡眠障碍。为了取得更好的效果，需要设计更有针对性的干预方案和操作性更强的平台。

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

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.