背景:对进展的恐惧(FOP)是癌症患者中常见且重要的问题,包括对积极治疗期间癌症进展的担忧。FOP水平升高可能是功能失调。本研究旨在评估基于接受和承诺疗法(ACT)的干预措施对FOP的疗效。焦虑敏感性(AS),和乳腺癌患者的生活质量(QOL)。
方法:进行了一项临床试验,涉及80名I-III期积极治疗的乳腺癌患者,其在恐惧进展问卷-简短形式量表上得分大于34分。这些患者以1:1的比例随机分配到干预组,每周接受70分钟的5-ACT-bsed组治疗,或接受常规治疗的对照组。变量包括FOP,AS,QOL,使用ASQ评估ACT相关因素,QLQ-C30,认知融合问卷,以及三个时间点的接受和行动问卷-II:基线,干预后,和3个月的随访。在所有时间点使用混合模型分析评估干预的有效性。
结果:使用有意义的方法确认了基于ACT的手册的保真度和可接受性。干预后,仅在ACT组中观察到FOP的显着降低(P值ACT<0.001;CohendACT=1.099)。此外,ACT组随访时FOP的减少更为显著.此外,所有次要和ACT相关变量,除了身体症状分量表,与对照组相比,ACT组显着改善。
结论:我们基于ACT的手册显示出减少FOP的希望,AS,提高生活质量,干预后3个月,乳腺癌患者的ACT相关变量。
BACKGROUND: Fear 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.
METHODS: A 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.
RESULTS: The 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.
CONCLUSIONS: Our 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.