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A randomized clinical trial: Efficacy of group-based acceptance and commitment therapy program for breast cancer patients with high fear of progression. 随机临床试验:以小组为基础的接受与承诺治疗计划对高度恐惧病情恶化的乳腺癌患者的疗效。
Pub Date : 2024-04-01 DOI: 10.1002/pon.6339
Fatemeh Hassani Alimolk, F. McDonald, Mohammad Asghari-Jafarabadi, F. Ahmadi, Saeedeh Zenoozian, M. Lashkari, Pandora Patterson
BACKGROUNDFear of progression (FOP) is a common and significant concern among cancer patients, encompassing worries about cancer progression during active treatment. Elevated levels of FOP can be dysfunctional. This study aims to assess the efficacy of an Acceptance and Commitment Therapy (ACT)-based intervention on FOP, anxiety sensitivity (AS), and quality of life (QOL) in breast cancer patients.METHODSA clinical trial was conducted involving 80 stage I-III active-treatment breast cancer patients with a score greater than 34 on the Fear of Progression Questionnaire-Short Form scale. These patients were randomly assigned in a 1:1 ratio to either an intervention group, which received weekly 70-min sessions of 5-ACT-bsed group-therapy, or a control group that received usual treatment. Variables including FOP, AS, QOL, and ACT-related factors were assessed using ASQ, QLQ-C30, Cognitive Fusion Questionnaire, and Acceptance and Action Questionnaire-II at three time points: baseline, post-intervention, and 3-month follow-up. The efficacy of the intervention was evaluated using mixed model analysis across all time-points.RESULTSThe fidelity and acceptability of the ACT-based manual were confirmed using significant methods. A significant reduction in FOP was observed only in the ACT group at post-intervention (P-valueACT < 0.001; Cohen dACT = 1.099). Furthermore, the ACT group demonstrated a more significant reduction in FOP at follow-up. Furthermore, all secondary and ACT-related variables, except for the physical symptoms subscale, showed significant improvement in the ACT group compared to the control group.CONCLUSIONSOur ACT-based manual showed promise for reducing FOP, AS, and improving QOL, and ACT-related variables in breast cancer patients 3 months following the intervention.
背景癌症进展恐惧(FOP)是癌症患者普遍存在的一个重要问题,包括在积极治疗期间对癌症进展的担忧。FOP 水平升高会导致功能障碍。本研究旨在评估以接纳与承诺疗法(ACT)为基础的干预措施对乳腺癌患者的恐惧进展、焦虑敏感性(AS)和生活质量(QOL)的疗效。方法本研究进行了一项临床试验,涉及 80 名正在接受治疗的 I-III 期乳腺癌患者,这些患者的恐惧进展问卷短表得分大于 34 分。这些患者按 1:1 的比例被随机分配到干预组(每周接受 70 分钟的 5-ACT-bsed 团体治疗)或对照组(接受常规治疗)。在基线、干预后和 3 个月随访三个时间点,使用 ASQ、QLQ-C30、认知融合问卷和接受与行动问卷-II 对包括 FOP、AS、QOL 和 ACT 相关因素在内的变量进行评估。结果采用显著方法证实了基于 ACT 手册的忠实性和可接受性。干预后,仅在 ACT 组观察到 FOP 明显减少(P 值ACT < 0.001;Cohen dACT = 1.099)。此外,在随访中,ACT 组的 FOP 下降幅度更大。此外,与对照组相比,ACT 组除躯体症状分量表外,所有次要变量和 ACT 相关变量均有显著改善。
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引用次数: 0
Cognitive impairment in cervical cancer survivors—Exploring the discrepancy between subjective and objective assessment 宫颈癌幸存者的认知障碍--探索主观和客观评估之间的差异
Pub Date : 2024-02-01 DOI: 10.1002/pon.6300
Cancer‐related cognitive impairment has severe implications for the quality of life and societal participation of cervical cancer survivors (CCS). However, there is no research on the association between subjective and objective cognitive impairment (CI) in cervical cancer. This cross‐sectional study aimed to examine the frequency and severity of objective CI in CCS reporting significant subjective CI and explore the discrepancy between subjective and objective CI.Sixty‐five CCS reporting significant subjective CI, defined as 1.5 SD below the normative mean, underwent neuropsychological (NP) assessment covering attention, verbal memory, processing speed, verbal fluency, and executive functions. CCS were compared to healthy age‐matched controls (n = 74). A subjective versus objective discrepancy score was calculated based on the standardized scores within each group.The CCS group performed significantly poorer across all NP tests compared to healthy controls (all p‐values <0.001) and 81.5% had scores below cut‐off as defined by the International Cognition and Cancer Task Force. However, compared to published normative data, most CCS performed within the clinically normal range. Processing speed and verbal memory were the most affected cognitive domains. By calculating a discrepancy score, both groups on average displayed a quite accurate concordance between subjective and objective cognitive functioning.Although CI is evident in CCS, our results confirm that objective and subjective CI represent different constructs and highlight the limitations of normative data. Differentiating subjective and objective CI is important when tailoring effective interventions in the survivorship care of CCS.
与癌症相关的认知障碍严重影响了宫颈癌幸存者(CCS)的生活质量和社会参与。然而,目前还没有关于宫颈癌主观和客观认知障碍(CI)之间关系的研究。这项横断面研究旨在检查报告有明显主观认知障碍的宫颈癌幸存者中客观认知障碍的频率和严重程度,并探讨主观和客观认知障碍之间的差异。65 名报告有明显主观认知障碍的宫颈癌幸存者(定义为低于常模平均值 1.5 SD)接受了神经心理学(NP)评估,评估内容包括注意力、言语记忆、处理速度、言语流畅性和执行功能。CCS 与年龄匹配的健康对照组(n = 74)进行了比较。与健康对照组相比,CCS 组在所有 NP 测试中的表现明显较差(所有 P 值均小于 0.001),81.5% 的得分低于国际认知与癌症工作组所定义的临界值。不过,与已公布的常模数据相比,大多数 CCS 的表现在临床正常范围内。处理速度和言语记忆是受影响最大的认知领域。虽然CI在CCS中很明显,但我们的研究结果证实,客观和主观CI代表了不同的结构,并强调了常模数据的局限性。区分主观和客观 CI 对于为 CCS 患者的生存期护理量身定制有效的干预措施非常重要。
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引用次数: 0
Effects of aerobic exercise on neurocognitive function in postmenopausal women receiving endocrine therapy for breast cancer: The Exercise Program in Cancer and Cognition randomized controlled trial 有氧运动对接受乳腺癌内分泌治疗的绝经后妇女神经认知功能的影响:癌症与认知锻炼计划随机对照试验
Pub Date : 2024-01-29 DOI: 10.1002/pon.6298
The Exercise Program in Cancer and Cognition Study was a randomized controlled trial designed to determine whether 6 months of moderate‐intensity aerobic exercise improves neurocognitive function in women with breast cancer (BC) receiving endocrine therapy (ET).Postmenopausal women with hormone receptor+, early‐stage BC, within two years post‐primary therapy were randomized to the exercise intervention (six months, ≥150 min of moderate‐intensity aerobic exercise/week) or usual care control condition. Outcomes were assessed at pre‐randomization and after intervention completion. Groups were compared using linear mixed‐effects modeling.Participants (N = 153) were  = 62.09 ± 8.27 years old, with stage I BC (64.1%) and a median of 4.7 months post‐diagnosis. We found a group‐by‐time interaction (p = 0.041) and a trend for the main effect of time (p = 0.11) for processing speed with improved performance in the exercise group and no change in the controls. Similar main effects of time were observed for learning and memory (p = 0.024) and working memory (p = 0.01). Better intervention adherence was associated with improved processing speed (p = 0.017).Six months of moderate‐intensity aerobic exercise improves processing speed in postmenopausal women with BC receiving ET who initiate exercise within 2 years of completing primary therapy (surgery +/− chemotherapy). This is the first large‐scale study to examine the effects of aerobic exercise on neurocognitive function in women with BC. Additional research is needed to address the long‐term effects of aerobic exercise on cognitive function.
癌症与认知锻炼计划研究是一项随机对照试验,旨在确定为期6个月的中等强度有氧运动是否能改善接受内分泌治疗(ET)的乳腺癌(BC)女性患者的神经认知功能。患有激素受体+、早期BC、初级治疗后两年内的绝经后女性患者被随机分配到锻炼干预(为期6个月、中等强度有氧运动≥150分钟/周)或常规护理对照组。结果在随机前和干预完成后进行评估。参与者(N = 153)的年龄为 62.09 ± 8.27 岁,BC 期为 I 期(64.1%),诊断后的中位时间为 4.7 个月。我们发现了组间时间交互作用(p = 0.041)和时间主效应趋势(p = 0.11),运动组的处理速度有所提高,而对照组则没有变化。在学习记忆(p = 0.024)和工作记忆(p = 0.01)方面也观察到了类似的时间主效应。6个月的中等强度有氧运动可提高接受ET治疗的绝经后BC妇女的处理速度,这些妇女在完成主要治疗(手术+/-化疗)后2年内开始运动。这是首次大规模研究有氧运动对 BC 女性患者神经认知功能的影响。还需要更多的研究来探讨有氧运动对认知功能的长期影响。
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Psycho-Oncology
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