Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial.
Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial.
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DOI：
10.1017/s0033291717000447
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发表时间：
2017-08
影响因子：
6.9
通讯作者：
Verdonck-de Leeuw IM
中科院分区：
文献类型：
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作者：
van der Spek N;Vos J;van Uden-Kraan CF;Breitbart W;Cuijpers P;Holtmaat K;Witte BI;Tollenaar RAEM;Verdonck-de Leeuw IM
本研究的目的是评估以意义为中心的癌症幸存者团体心理治疗(MCGP-CS)与支持性团体心理治疗(SGP)和照常照看(CAU)相比，提高个人意义的有效性。总共170名癌症幸存者被随机分配到三个研究分支之一：MCGP-CS(n=57)，SGP(n=56)，CAU(n=57)。主要结果测量为个人意义描述(总分PMP)。次要结果量表包括PMP、心理幸福感(SPWB)、创伤后成长(PTGI)、癌症心理适应(MAC)、乐观(LOT-R)、绝望(BHS)、心理苦恼(焦虑和抑郁，HADS)和生活质量(EORTC QLQ-C30)。在随机化前、干预后、3个月和6个月随访(FU)后评估结果。线性混合模型分析(意向处理)显示，MCGP-CS、SGP和CAU在PMP总分以及PMP、SPWB、MAC和HADS的子量表上存在显著差异。治疗后分析显示，MCGP-CS在个人意义(d=0.81)、目标导向(d=1.07)、积极关系(d=0.59)、生活目标(d=0.69)、战斗精神(d=0.61)(干预后)、无助/无望(d=−0.87)(3个月FU)、苦恼(d=−0.6)和抑郁(d=−0.38)(6个月FU)方面显著优于CAU。与SGP相比，MCGP-CS对个人成长(d=0.57)(3个月FU)和环境掌握(d=0.66)(6个月FU)的影响显著增强。MCGP-CS是癌症幸存者在短期内改善癌症患者的个人意义、心理幸福感和心理适应，在长期内减少心理痛苦的有效干预工具。
The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared to supportive group psychotherapy (SGP) and care as usual (CAU). A total of 170 cancer survivors were randomly assigned to one of the three study arms: MCGP-CS (n = 57), SGP (n = 56), CAU (n = 57). Primary outcome measure was Personal Meaning Profile (total score PMP). Secondary outcome measures were subscales of the PMP, psychological well-being (SPWB), posttraumatic growth (PTGI), mental adjustment to cancer (MAC), optimism (LOT-R), hopelessness (BHS), psychological distress (anxiety and depression, HADS), and quality of life (EORTC QLQ-C30). Outcome measures were assessed before randomization, post-intervention, after three and six months follow-up (FU). Linear mixed model analyses (intention-to-treat) showed significant differences between MCGP-CS, SGP and CAU on the total PMP score, and on (sub)scales of the PMP, SPWB, MAC, and HADS. Post-hoc analyses showed significantly stronger treatment effects of MCGP-CS compared to CAU on personal meaning (d=0.81), goal-orientedness (d=1.07), positive relations (d=0.59), purpose in life (d=0.69); fighting spirit (d=0.61) (post-intervention), helpless/hopeless (d=−0.87) (3 months FU); distress (d=−0.6) and depression (d=−0.38) (6 months FU). Significantly stronger effects of MCGP-CS compared to SGP were found on personal growth (d=0.57) (3 months FU), and environmental mastery (d=0.66) (6 months FU). MCGP-CS is an effective intervention for cancer survivors to improve personal meaning, psychological well-being and mental adjustment to cancer in the short term, and to reduce psychological distress in the long run.