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12.01.2018 | Original Article

Acceptance and commitment therapy for symptom interference in metastatic breast cancer patients: a pilot randomized trial

verfasst von: Catherine E. Mosher, Ekin Secinti, Ruohong Li, Adam T. Hirsh, Jonathan Bricker, Kathy D. Miller, Bryan Schneider, Anna Maria Storniolo, Lida Mina, Erin V. Newton, Victoria L. Champion, Shelley A. Johns

Erschienen in: Supportive Care in Cancer | Ausgabe 6/2018

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Abstract

Purpose

Breast cancer is the leading cause of cancer mortality in women worldwide. With medical advances, metastatic breast cancer (MBC) patients often live for years with many symptoms that interfere with activities. However, there is a paucity of efficacious interventions to address symptom-related suffering and functional interference. Thus, this study examined the feasibility and preliminary efficacy of telephone-based acceptance and commitment therapy (ACT) for symptom interference with functioning in MBC patients.

Methods

Symptomatic MBC patients (N = 47) were randomly assigned to six telephone sessions of ACT or six telephone sessions of education/support. Patients completed measures of symptom interference and measures assessing the severity of pain, fatigue, sleep disturbance, depressive symptoms, and anxiety.

Results

The eligibility screening rate (64%) and high retention (83% at 8 weeks post-baseline) demonstrated feasibility. When examining within-group change, ACT participants showed decreases in symptom interference (i.e., fatigue interference and sleep-related impairment; Cohen’s d range = − 0.23 to − 0.31) at 8 and 12 weeks post-baseline, whereas education/support participants showed minimal change in these outcomes (d range = − 0.03 to 0.07). Additionally, at 12 weeks post-baseline, ACT participants showed moderate decreases in fatigue and sleep disturbance (both ds = − 0.43), whereas education/support participants showed small decreases in these outcomes (ds = − 0.24 and − 0.18 for fatigue and sleep disturbance, respectively). Both the ACT and education/support groups showed reductions in depressive symptoms (ds = − 0.27 and − 0.28) at 12 weeks post-baseline. Group differences in all outcomes were not statistically significant.

Conclusions

ACT shows feasibility and promise in improving fatigue and sleep-related outcomes in MBC patients and warrants further investigation.

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Titel: Acceptance and commitment therapy for symptom interference in metastatic breast cancer patients: a pilot randomized trial
verfasst von: Catherine E. Mosher
Ekin Secinti
Ruohong Li
Adam T. Hirsh
Jonathan Bricker
Kathy D. Miller
Bryan Schneider
Anna Maria Storniolo
Lida Mina
Erin V. Newton
Victoria L. Champion
Shelley A. Johns
Publikationsdatum: 12.01.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 6/2018
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4045-0

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Acceptance and commitment therapy for symptom interference in metastatic breast cancer patients: a pilot randomized trial