Supportive-expressive group therapy and distress in patients with metastatic breast cancer - A randomized clinical intervention trial
Supportive-expressive group therapy and distress in patients with metastatic breast cancer - A randomized clinical intervention trial
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DOI：
10.1001/archpsyc.58.5.494
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发表时间：
2001-05-01
影响因子：
--
通讯作者：
Spiegel, D
中科院分区：
文献类型：
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作者：
Classen, C;Butler, LD;Spiegel, D
背景：转移性乳腺癌伴随着相当多的心理社会疾病。研究表明，一些转移性乳腺癌患者会出现临床上显著的焦虑、抑郁和创伤应激症状。支持性表达团体心理治疗的发展，以帮助癌症患者面对和调整他们存在的问题，表达和管理疾病相关的情绪，增加社会支持，加强与家人和医生的关系，并改善症状control.Methods：125名妇女与转移性乳腺癌招募到研究中，64人随机干预和61对照条件。干预妇女提供1年的每周连续表达的团体治疗和教育材料。对照组妇女只收到教育材料。参与者在基线和第一年每4个月进行一次评估。在这12个月期间，从102名参与者中收集了基线数据和至少1次评估的数据，这些参与者组成了研究人群。基于所有可用数据的初步分析表明，治疗条件下的参与者在事件影响量表上的创伤应激症状明显下降（效应量为0.25），但心境状态量表总心境障碍无差异。然而，当死亡后一年内发生的最终评估被删除时，二次分析显示总情绪障碍的下降幅度更大（效应父系，0.25）和创伤应激症状（效应量，0.33）。结论：支持表达疗法，其重点是提供支持，帮助患者面对和处理与疾病相关的压力，可以帮助减少转移性乳腺癌患者的痛苦。
Background: Metastatic breast cancer carries with it considerable psychosocial morbidity. Studies have shown that some patients with metastatic breast cancer experience clinically significant anxiety and depression and traumatic stress symptoms. Supportive-expressive group psychotherapy was developed to help patients with cancer face and adjust to their existential concerns, express and manage disease-related emotions, increase social support, enhance relationships with family and physicians, and improve symptom control.Methods: Of 125 women with metastatic breast cancer recruited into the study, 64 were randomized to the intervention and 61 to the control condition. Intervention women were offered 1 year of weekly supportive-expressive group therapy and educational materials. Control women received educational materials only. Participants were assessed at baseline and every 4 months during the first year. Data at baseline and from at least 1 assessment were collected from 102 participants during this 12-month period, and these participants compose the study population.Results: Primary analyses based on all available data indicated that participants in the treatment condition showed a significantly greater decline in traumatic stress symptoms on the Impact of Event Scale (effect size, 0.25) compared with the control condition,but there was no difference in Profile of Mood States total mood disturbance. However, when the final assessment occurring within a year of death was removed, a secondary analysis showed a significantly greater decline in total mood disturbance (effect sire, 0.25) and traumatic stress symptoms (effect size, 0.33) for the treatment condition compared with the control condition.Conclusion: Supportive-expressive therapy, with its emphasis on providing support and helping patients face and deal with their disease-related stress, can help reduce distress in patients with metastatic breast cancer.