Pilot randomized controlled trial of a patient-controlled cognitive-behavioral intervention for the pain, fatigue, and sleep disturbance symptom cluster in cancer.
Pilot randomized controlled trial of a patient-controlled cognitive-behavioral intervention for the pain, fatigue, and sleep disturbance symptom cluster in cancer.
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DOI：
10.1016/j.jpainsymman.2011.12.281
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发表时间：
2012-12
影响因子：
4.7
通讯作者：
Ward, Sandra E.
中科院分区：
文献类型：
--
作者：
Kwekkeboom, Kristine L.;Abbott-Anderson, Kristen;Cherwin, Catherine;Roiland, Rachel;Serlin, Ronald C.;Ward, Sandra E.
接受晚期癌症治疗的患者通常会同时出现疼痛、疲劳和睡眠障碍。进行了一项随机对照试验，以评估患者自控认知行为 (CB) 干预对疼痛、疲劳、睡眠障碍症状群的初步疗效。 86 名在综合癌症中心接受治疗的晚期肺癌、前列腺癌、结直肠癌或妇科癌症患者按招募诊所（化疗、放疗）进行分层，并随机分为干预组或对照组。在癌症治疗期间，43 名患者被分配接受为期两周的培训和使用通过 MP3 播放器提供的多达 12 种放松、想象或分散注意力的练习。 43 名患者在同一两周内被分配到候补对照条件组。结果包括基线（时间 1）和两周后（时间 2）测量的症状群严重程度和总体症状对日常生活的干扰。八名参与者退出； 78 人完成了研究并进行了分析（36 人为干预组，42 人为对照组）。参与者平均使用 CB 策略 13.65 次（SD = 6.98）。控制基线症状群严重程度和其他相关协变量后，干预组在时间 2 时的症状群严重程度 (MAdj=2.99, SE=0.29) 低于候补组 (MAdj=3.87, SE=0.36)，F(1,65)=3.57，P=0.032。对日常生活的症状干扰在各组之间没有差异。 CB 干预没有发现重大不良事件。研究结果表明，CB 干预可能是治疗疼痛、疲劳、睡眠障碍症状群的有效方法。未来的研究计划确认疗效并测试干预效果的中介因素和调节因素。
Pain, fatigue and sleep disturbance commonly co-occur in patients receiving treatment for advanced cancer. A pilot randomized controlled trial was conducted to assess initial efficacy of a patient-controlled cognitive-behavioral (CB) intervention for the pain, fatigue, sleep disturbance symptom cluster. Eighty-six patients with advanced lung, prostate, colorectal, or gynecologic cancers receiving treatment at a comprehensive cancer center were stratified by recruitment clinic (chemotherapy, radiation therapy) and randomized to intervention or control groups. Forty-three patients were assigned to receive training in and use of up to 12 relaxation, imagery, or distraction exercises delivered via MP3 player for two weeks during cancer treatment. Forty-three patients were assigned to a waitlist control condition for the same two-week period. Outcomes included symptom cluster severity and overall symptom interference with daily life measured at baseline (Time 1) and two weeks later (Time 2). Eight participants dropped out; 78 completed the study and were analyzed (36 intervention, 42 control). Participants used the CB strategies an average of 13.65 times (SD= 6.98). Controlling for baseline symptom cluster severity and other relevant covariates, symptom cluster severity at Time 2 was lower in the intervention group (MAdj=2.99, SE=0.29) than in the waitlist group (MAdj=3.87, SE=0.36), F(1,65)=3.57, P=0.032. Symptom interference with daily life did not differ between groups. No significant adverse events were noted with the CB intervention. Findings suggest that the CB intervention may be an efficacious approach to treating the pain, fatigue, sleep disturbance symptom cluster. Future research is planned to confirm efficacy and to test mediators and moderators of intervention effects.
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影响因子：
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作者：
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通讯作者：
Devine, Elizabeth C
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