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Pilot randomized controlled trial of a symptom cluster intervention in advanced cancer.

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Title: Pilot randomized controlled trial of a symptom cluster intervention in advanced cancer.
Authors: Wells‐Di Gregorio, Sharla M., Marks, Donald R., DeCola, Joseph, Peng, Juan, Probst, Danielle, Zaleta, Alexandra, Benson, Don, Cohn, David E., Lustberg, Maryam, Carson, William E., Magalang, Uly, Wells-Di Gregorio, Sharla M
Source: Psycho-Oncology. Jan2019, Vol. 28 Issue 1, p76-84. 9p. 3 Charts, 1 Graph.
Subjects: Evaluation research, Research funding, Fatigue (Physiology), Pilot projects, Insomnia, Statistical sampling, Severity of illness index, Treatment effectiveness, Randomized controlled trials, Research methodology, Research, Acceptance & commitment therapy, Tumors, Comparative studies, Mental depression, Disease complications, Psychosocial factors
Abstract: Objective: This study evaluated a three-session acceptance-based cognitive behavioral -acceptance and commitment therapy (CBT-ACT) intervention targeting a common symptom cluster in advanced cancer-worry-insomnia-depression-fatigue.Methods: Twenty-eight patients with advanced cancer were randomly assigned to the CBT-ACT intervention or waitlist. At preintervention, participants completed a psychodiagnostic interview, standardized questionnaires, and a sleep diary. Intervention and waitlist groups were reassessed after 6 weeks, at which point the waitlist group completed the intervention.Results: Participants receiving the intervention demonstrated improved sleep efficiency (P = 0.0062, d = 1.08), sleep latency (P = 0.028, d = -0.86), insomnia severity (P = 0.0047, d = -1.18), and worry (P = 0.026, d = -0.89) compared with waitlist controls. They also demonstrated a 7-point reduction on depression (P = 0.03, d = -0.88), reduced hyperarousal (P = 0.005, d = -1.51), and a decrease in distress (P = 0.032, d = -0.83). Effects were maintained for the whole sample in sensitivity analyses. Effects on uncertainty intolerance approached significance (P = 0.058). No effect was found on fatigue.Conclusions: The CBT-ACT group performed significantly better than the waitlist control group. CBT-ACT yielded strong effects for worry, sleep, depression, emotional distress, total distress, and hyperarousal. Future studies will enhance the fatigue and uncertainty tolerance components of the intervention. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
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Abstract:<bold>Objective: </bold>This study evaluated a three-session acceptance-based cognitive behavioral -acceptance and commitment therapy (CBT-ACT) intervention targeting a common symptom cluster in advanced cancer-worry-insomnia-depression-fatigue.<bold>Methods: </bold>Twenty-eight patients with advanced cancer were randomly assigned to the CBT-ACT intervention or waitlist. At preintervention, participants completed a psychodiagnostic interview, standardized questionnaires, and a sleep diary. Intervention and waitlist groups were reassessed after 6 weeks, at which point the waitlist group completed the intervention.<bold>Results: </bold>Participants receiving the intervention demonstrated improved sleep efficiency (P = 0.0062, d = 1.08), sleep latency (P = 0.028, d = -0.86), insomnia severity (P = 0.0047, d = -1.18), and worry (P = 0.026, d = -0.89) compared with waitlist controls. They also demonstrated a 7-point reduction on depression (P = 0.03, d = -0.88), reduced hyperarousal (P = 0.005, d = -1.51), and a decrease in distress (P = 0.032, d = -0.83). Effects were maintained for the whole sample in sensitivity analyses. Effects on uncertainty intolerance approached significance (P = 0.058). No effect was found on fatigue.<bold>Conclusions: </bold>The CBT-ACT group performed significantly better than the waitlist control group. CBT-ACT yielded strong effects for worry, sleep, depression, emotional distress, total distress, and hyperarousal. Future studies will enhance the fatigue and uncertainty tolerance components of the intervention. [ABSTRACT FROM AUTHOR]
ISSN:10579249
DOI:10.1002/pon.4912