A Hope-Based Intervention to Address Disrupted Goal Pursuits and Quality of Life Among Young Adult Cancer Survivors
A Hope-Based Intervention to Address Disrupted Goal Pursuits and Quality of Life Among Young Adult Cancer Survivors
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DOI：
10.1007/s13187-019-01574-7
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发表时间：
2020-12-01
影响因子：
1.6
通讯作者：
Mertens, Ann
中科院分区：
文献类型：
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作者：
Berg, Carla J.;Vanderpool, Robin C.;Mertens, Ann
每年有超过 70,000 名美国年轻人被诊断患有癌症，扰乱了重要的人生转变和目标追求。希望是一种与更好的生活质量 (QOL) 相关的积极心理学结构，注重以目标为导向的思维。我们开发并测试了在早期生活中实现癌症后的健康 (AWAKE)，这是一个可扩展的为期 8 周的基于应用程序的计划，包括教育视频、情绪/活动跟踪和基于电话的辅导，以促进年轻成年癌症幸存者（YACS，18-40 岁）的希望和生活质量。一项双臂随机对照试验用于检验 YACS 中 AWAKE（n = 38）与注意力控制（AC；n = 18）在完成治疗后 2 年内的可行性、可接受性和潜在疗效，并从两个 NCI 指定的癌症中心招募。在基线、第 8 周和第 6 个月评估了包括希望（特质希望量表）、生活质量（36 项简短健康调查；癌症治疗功能评估 - 一般）、抑郁症状（患者健康问卷 9）和物质使用在内的结果。参与者平均年龄为 32.55 (SD = 5.45) 岁； 75.0% 为女性，80.4% 为白人。最常见的癌症是乳腺癌（28.6%）、黑色素瘤（16.1%）和白血病/淋巴瘤（12.5%）。在这两种情况下，都记录了很高的保留率、参与度和满意度； AWAKE 与 AC 参与者相比，认为视频内容更相关（p = 0.007），并表示积极谈论该计划的可能性更大（p = 0.005）。 AWAKE 与 AC 相比，许多功效变化评分显示出积极的趋势。在癌症诊断和治疗后重新调整自己的目标追求至关重要，并且可以通过基于希望的干预措施得到支持。研究结果表明，AWAKE 值得后续研究测试其功效、有效性和可扩展性。
Over 70,000 US young adults are diagnosed with cancer annually, disrupting important life transitions and goal pursuits. Hope is a positive psychology construct associated with better quality of life (QOL) that focuses on goal-oriented thinking. We developed and tested Achieving Wellness After Kancer in Early life (AWAKE), a scalable 8-week app-based program consisting of educational videos, mood/activity tracking, and telephone-based coaching to promote hope and QOL in young adult cancer survivors (YACS, 18-40 years old). A two-arm RCT was used to examine the feasibility, acceptability, and potential efficacy of AWAKE (n = 38) versus attention control (AC; n = 18) among YACS within 2 years of completing treatment and recruited from two NCI-designated cancer centers. Outcomes including hope (Trait Hope Scale), QOL (36-Item Short Form Health Survey; Functional Assessment of Cancer Therapy-General), depressive symptoms (Patient Health Questionnaire-9), and substance use were assessed at baseline, 8 weeks, and 6 months. Participants were an average of 32.55 (SD = 5.45) years old; 75.0% were female, and 80.4% White. The most common cancers were breast cancer (28.6%), melanoma (16.1%), and leukemia/lymphoma (12.5%). High retention, engagement, and satisfaction rates were documented in both conditions; AWAKE versus AC participants rated video content as more relevant (p = 0.007) and reported greater likelihood of talking positively about the program (p = 0.005). Many efficacy change scores showed positive trends in AWAKE versus AC. Reorienting to one's goal pursuits after cancer diagnosis and treatment is critical and may be supported through hope-based interventions. Findings suggest that the AWAKE warrants subsequent research testing its efficacy, effectiveness, and scalability.