Mei Bai, David Cella, Sangchoon Jeon, Rang Govindarajan, Michael J Birrer
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引用次数: 0
Abstract
Objective: Cancer diagnosis represents a life crisis. It remains unclear whether/what psychosocial intervention may enhance cancer patients' quality of life (QoL) during existential plight. This study aimed to examine preliminary efficacy of a brief writing intervention for patients newly diagnosed with advanced cancer with a focus on affirming personally important values and beliefs.
Methods: This is a single-arm pilot study testing effect of a 4-week home-based self-affirmation writing intervention for patients newly diagnosed with advanced cancer using interrupted time series design (NCT05235750). Patients were eligible if they were newly diagnosed (within 8 weeks) with advanced stage (III or IV) or recurrent cancer. Longitudinal analyses were performed using generalized linear mixed model incorporating the correlation of repeated measures. All statistical analyses were performed at 5% significance level using SAS® (version 9.4).
Results: Fifty-seven patients newly diagnosed with advanced stage cancer with a mean age of 63 years balanced in gender were enrolled. Intent-to-treat analysis revealed significant post-intervention change for Faith as measured by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 item scale (FACIT-Sp-12) (ES 0.23, p = .05) and Ge6 "I worry that my condition will get worse" as measured by the Functional Assessment of Cancer Therapy - General (FACT-G) (ES 0.26, p = .10). When comparing changes pre- and post-intervention, Ge6 remained clinically significant (ESΔ 0.36, p = .27).
Conclusions: Self-affirmation via writing showed initial short-term efficacy in relieving cancer-specific existential concerns (Ge6 "I worry that my condition will get worse") and may be a promising innovative intervention approach that warrant randomized experiments to verify. Further research is also needed to find out who may most likely benefit from this intervention.
目的：癌症诊断代表着一种生命危机。在生存困境中，社会心理干预是否或以何种方式提高癌症患者的生活质量（QoL）仍不清楚。本研究旨在考察简短的写作干预对新诊断为晚期癌症的患者的初步疗效，重点是肯定个人重要的价值观和信仰。方法：这是一项单臂先导研究，采用中断时间序列设计（NCT05235750），对新诊断的晚期癌症患者进行为期4周的以家庭为基础的自我肯定写作干预的效果进行测试。如果患者新诊断为晚期（III或IV）或复发癌症（8周内），则符合条件。采用包含重复测量相关性的广义线性混合模型进行纵向分析。所有统计分析均采用SAS®（version 9.4）在5%显著性水平下进行。结果：57例新诊断的晚期癌症患者入组，平均年龄63岁，性别平衡。意向治疗分析显示，干预后，慢性疾病治疗功能评估-精神健康12项量表（FACIT-Sp-12）测量的信念（ES 0.23, p = 0.05）和癌症治疗功能评估-一般（FACT-G）测量的Ge6“我担心我的病情会恶化”（ES 0.26, p = 0.10）发生了显著变化。当比较干预前后的变化时，Ge6仍然具有临床意义（ESΔ 0.36, p = 0.27）。结论：通过书写的自我肯定在缓解癌症特异性存在性担忧（“我担心我的病情会变得更糟”）方面显示出初步的短期疗效，可能是一种有希望的创新干预方法，需要随机实验来验证。还需要进一步的研究来找出谁最有可能从这种干预中受益。
期刊介绍：
Here is your single source of integrated information on providing the best psychosocial care possible from the knowledge available from many disciplines.The Journal of Psychosocial Oncology is an essential source for up-to-date clinical and research material geared toward health professionals who provide psychosocial services to cancer patients, their families, and their caregivers. The journal—the first interdisciplinary resource of its kind—is in its third decade of examining exploratory and hypothesis testing and presenting program evaluation research on critical areas, including: the stigma of cancer; employment and personal problems facing cancer patients; patient education.
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