Effect of neutropenia on the impact of a cognitive-behavioral intervention for symptom management.
Effect of neutropenia on the impact of a cognitive-behavioral intervention for symptom management.
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中性粒细胞减少症对认知行为干预对症状管理的影响。
DOI：
10.1002/cncr.21240
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Sikorskii,Alla
中科院分区：
文献类型：
--
作者：
Given,BarbaraA;Given,CharlesW;Jeon,Sanchoon;Sikorskii,Alla
背景：旨在减轻症状严重程度或改善生活质量的认知行为干预（CBI）试验很少考虑治疗的副作用或疾病或治疗引起的并发症如何缓和试验对指定结果的影响。为了解决这个问题，在接受化疗的癌症患者中评估了中性粒细胞减少对CBI减轻症状严重程度的影响的调节作用。方法：作者描述了10次接触、20周CBI对症状严重程度的随机试验的影响，以及20周中性粒细胞减少发作对症状严重程度的缓和作用。严重程度评分基于15种症状的总评分（0-10）。结果20周时中性粒细胞减少症的严重程度受年龄（年轻）和组的影响，两组之间存在相互作用。在无中性粒细胞减少迹象的患者中，实验组患者在20周时的严重程度评分降低了9分。在经历中性粒细胞减少症的患者中，试验各组症状严重程度的差异< 3分。此外，疲劳、发热和疼痛在中性粒细胞减少症患者中更为普遍。结论：经历中性粒细胞减少的患者并没有从CBI中获益以减轻症状。这种干预的总体效果几乎完全来自无中性粒细胞减少症的患者。2005年癌症。©2005美国癌症协会。
BACKGROUNDTrials of cognitive‐behavioral interventions (CBI) designed to reduce symptom severity or improve dimensions of quality of life seldom consider how the side effects of treatment or the complications imposed by the disease or treatment may moderate the impact of the trial on the designated outcome. To address this issue, the moderating effect of neutropenia on the impact of a CBI for reducing symptom severity was evaluated among patients with cancer undergoing chemotherapy.METHODSThe authors described the impact of a randomized trial of a 10‐contact, 20‐week CBI on symptom severity, as well as the moderating effect of a neutropenic episode on symptom severity at 20 weeks. Severity scores were based on sum scores (0–10) for 15 symptoms.RESULTSThere was an effect for age (younger) and group on severity at 20 weeks and an interaction between neutropenia and group. Among patients with no evidence of neutropenia, those in the experimental arm had a 9‐point lower severity score at 20 weeks. Among patients who experienced neutropenia, differences in symptom severity by arm of the trial were < 3 points. Further, fatigue, fever, and pain were more prevalent among patients with neutropenia.CONCLUSIONSPatients who experienced neutropenia did not benefit from a CBI to lower symptoms. The overall effect of this intervention came almost exclusively from patients without neutropenia. Cancer 2005. © 2005 American Cancer Society.