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一项针对拉丁裔乳腺癌患者的经文化适应、基于社区且通过远程交付的正念计划的随机对照试验是可接受且可行的,同时还能减轻焦虑。

A Randomized Controlled Trial of a Culturally Adapted, Community-Based, Remotely Delivered Mindfulness Program for Latinx Patients With Breast Cancer is Acceptable and Feasible While Reducing Anxiety.

作者信息

Juarez-Reyes Maria, Martinez Erica, Xiao Lan, Goldman Rosas Lisa

机构信息

Division of Primary Care and Population Health, Department of Medicine, Stanford University, Portola Valley, CA, USA.

Program in Medical Education for the Latino Community (PRIME-LC), School of Medicine, University of California, Irvine, CA, USA.

出版信息

Glob Adv Integr Med Health. 2024 Aug 16;13:27536130241274240. doi: 10.1177/27536130241274240. eCollection 2024 Jan-Dec.

Abstract

BACKGROUND/OBJECTIVE: Few Spanish mindfulness interventions have been evaluated in Latinx patients with cancer. We culturally adapted a mindfulness intervention for Spanish speaking Latinx patients. The objective was to measure feasibility and acceptability as primary outcomes, with changes in anxiety, depression, and sleep as secondary outcomes.

METHOD

Spanish-speaking Latinx patients with breast cancer (n = 31) were randomized, between April 2021 and May 2022 to either intervention or wait-list control groups. The mindfulness intervention consisted of 6-weekly 1.5-hour sessions remotely delivered by a novice facilitator. Cultural adaptations included language, metaphor, goal, concept, trauma informed, and acknowledgement of spirituality. Feasibility was benchmarked as 75% of participants attending their first session, 75% of participants completing 4 of 6 sessions, and scoring ≥ 4 on a 5-point Likert feasability scale measuring ability to implement changes after 6-weeks. Acceptability was measured as scoring ≥ 4 on a 5-point Likert scale measuring usefulness and relevance of the mindfulness intervention for each session. An intention-to-treat, linear mixed model with repeated measures analysis examined changes in anxiety, depression, and sleep at week 6 and 18 (3 months post intervention).

RESULTS

All three feasibility benchmarks were met with 75% of first session attendance, 96% of participants completing 4 of 6 sessions, and 94% scoring ≥ 4, on the feasibility scale (Mean (SD) = 4.3 (0.6)). Acceptability scores for both usefulness and relevance questions were ≥ 4 across all 6 sessions. Anxiety was significantly reduced at 3 months (-3.6 (CI -6.9, -0.2), = .04), but is of unclear clinical significance given the small change. Depression scores declined, but not significantly, and there were no changes in sleep.

CONCLUSION

This culturally adapted, remotely delivered mindfulness intervention using a novice facilitator was acceptable and feasible and demonstrated associated reductions in anxiety amongst Spanish speaking Latinx patients with breast cancer.

TRIAL REGISTRATION

ClinicalTrials.gov ID# NCT04834154.

摘要

背景/目的:针对拉丁裔癌症患者的西班牙语正念干预措施鲜有评估。我们对一项正念干预措施进行了文化调适,以适用于讲西班牙语的拉丁裔患者。目的是将可行性和可接受性作为主要结果进行衡量,将焦虑、抑郁和睡眠的变化作为次要结果。

方法

2021年4月至2022年5月期间,将31名讲西班牙语的拉丁裔乳腺癌患者随机分为干预组或等待名单对照组。正念干预包括由一名新手 facilitator远程进行的为期6周、每周1.5小时的课程。文化调适内容包括语言、隐喻、目标、概念、创伤知情以及对灵性的认可。可行性的基准是75%的参与者参加第一次课程,75%的参与者完成6次课程中的4次,并在5分量表上对6周后实施改变的能力进行可行性评分,得分≥4。可接受性通过在5分量表上对正念干预每次课程的有用性和相关性进行评分,得分≥4来衡量。采用意向性分析、带有重复测量分析的线性混合模型,在第6周和第18周(干预后3个月)检查焦虑、抑郁和睡眠的变化。

结果

所有三个可行性基准均达到,75%的患者参加了第一次课程,96%的参与者完成了6次课程中的4次,94%的参与者在可行性量表上得分≥4(均值(标准差)=4.3(0.6))。在所有6次课程中,有用性和相关性问题的可接受性得分均≥4。3个月时焦虑显著降低(-3.6(置信区间 -6.9,-0.2),P =.04),但鉴于变化较小,其临床意义尚不清楚。抑郁得分下降,但不显著,睡眠无变化。

结论

这种经过文化调适、由新手facilitator远程实施的正念干预是可接受且可行的,并表明对讲西班牙语的拉丁裔乳腺癌患者的焦虑有相关降低作用。

试验注册

ClinicalTrials.gov标识符#NCT04834154 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7414/11329901/59c6d4405ad4/10.1177_27536130241274240-fig1.jpg

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