Tailoring Cognitive-Behavioral Therapy to Treat Anxiety Comorbid with Advanced Cancer.
Tailoring Cognitive-Behavioral Therapy to Treat Anxiety Comorbid with Advanced Cancer.
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DOI：
10.1891/0889-8391.24.4.294
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发表时间：
2010-01-01
影响因子：
0.7
通讯作者：
Safren SA
中科院分区：
文献类型：
--
作者：
Greer JA;Park ER;Prigerson HG;Safren SA
晚期癌症患者通常会出现使人衰弱的焦虑症状，这些症状会影响生活质量，并与更差的医疗结果有关。虽然认知行为疗法（CBT）是一种经过临床验证的焦虑症的一线治疗方法，但CBT治疗焦虑症的临床试验通常排除患有医学合并症的患者，特别是患有晚期癌症的患者。此外，CBT通常针对具有临床显著焦虑症状的健康个体的不切实际的恐惧和担忧。因此，传统的CBT不能充分解决癌症患者焦虑的认知成分，特别是理性但侵入性和痛苦的消极思维模式，例如对疼痛，残疾和死亡的担忧，以及对多种压力源的管理，功能状态的变化和繁重的医疗治疗。在本文中，我们描述了一种治疗方法，用于定制CBT，以满足这一人群的需求。本文提供了三个被诊断为晚期肺癌患者的案例，以沿着焦虑和生活质量的治疗方法以及结果指标。
Patients with advanced cancer often experience debilitating anxiety symptoms that interfere with quality of life and relate to worse medical outcomes. Although cognitive behavioral therapy (CBT) is an empirically-validated, first-line treatment for anxiety disorders, clinical trials of CBT for anxiety typically exclude patients with medical comorbidities in general, and those with terminal illnesses, such as advanced cancer, in particular. Moreover, CBT has generally targeted unrealistic fears and worries in otherwise healthy individuals with clinically significant anxiety symptoms. Consequently, traditional CBT does not sufficiently address the cognitive components of anxiety in patients with cancer, especially negative thought patterns that are rational but nonetheless intrusive and distressing, such as concerns about pain, disability and death, as well as management of multiple stressors, changes in functional status and burdensome medical treatments. In this paper, we describe a treatment approach for tailoring CBT to the needs of this population. Three case examples of patients diagnosed with terminal lung cancer are presented to demonstrate the treatment methods along with outcome measures for anxiety and quality of life.