Sharla M Wells-Di Gregorio1,2, Donald R Marks1,2, Joseph DeCola3, Juan Peng4, Danielle Probst1,2, Alexandra Zaleta1,2, Don Benson5,6, David E Cohn7, Maryam Lustberg5,8, William E Carson5,9, Uly Magalang5,10. 1. Department of Psychiatry, The Ohio State University Wexner Medical Center, Columbus, Ohio. 2. Division of Psychology, The Ohio State University Wexner Medical Center, Columbus, Ohio. 3. Department of Psychology, The Ohio State University, Columbus, Ohio. 4. Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, Ohio. 5. Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio. 6. Division of Hematology-Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio. 7. Division of Gynecologic Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio. 8. Division of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio. 9. Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio. 10. Division of Pulmonary, Critical Care, and Sleep Medicine, Wexner Medical Center at The Ohio State University, Columbus, Ohio.
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.
RCT Entities:
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.
Authors: Emma J Chapman; Erica Di Martino; Zoe Edwards; Kathryn Black; Matthew Maddocks; Michael I Bennett Journal: Palliat Med Date: 2021-12-14 Impact factor: 4.762
Authors: Nicholas J Hulbert-Williams; Sabrina F Norwood; David Gillanders; Anne M Finucane; Juliet Spiller; Jenny Strachan; Susan Millington; Joseph Kreft; Brooke Swash Journal: BMC Palliat Care Date: 2021-06-25 Impact factor: 3.234