명상도서관
384 MINDFULNESS BASED STRESS REDUCTION DECREASES FEAR OF PROGRESSION OVER TIME FOR MEN WITH PROSTATE CANCER ON ACTIVE SURVEILLANCE RESULTS FROM A RANDOMIZED CLINICAL TRIAL
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- 자료유형학술지논문
- 저자명Victorson, D.,Du, H.,Hankin, V.,King, K.,McCurdy, M.,Pruitt, J.,Rabitt, S.,Dangle, P.,Novakovic, K.,McGuire, M.
- 학회/출판사/기관명ELSEVIER SCIENCE B.V. AMSTERDAM
- 출판년도2012
- 언어영어
- 학술지명/학위논문주기The Journal of urology
- 발행사항Vol.187No.4//SUP[2012]_x000D_
- ISBN/ISSN0022-5347
- 소개/요약INTRODUCTION AND OBJECTIVES Men diagnosed with prostate cancer (PC) may experience heightened anxiety and emotional distress, which is linked to disease and treatment related sequelae. Active Surveillance (AS) is an increasingly adopted disease management approach for men diagnosed with low grade PC who meet specific eligibility criteria. A subset of men who are clinically eligible for AS may opt for definitive treatment or prematurely leave AS for definitive treatment as a result of unmanageable stress, anxiety and uncertainty. The objective of this study is to examine whether an 8-week anxiety reduction intervention (Mindfulness Based Stress Reduction - MBSR) can decrease PC-associated anxiety for men with PC on AS. METHODS Study participants were randomly assigned to either an 8-week anxiety reduction intervention or an attention control. Measures of anxiety (MAX-PC) and other self-report scales were administered at multiple time points over the course of a year. We used a mixed-effects model for repeated measures to evaluate change over time for the three MAX-PC anxiety scores (PC Anxiety, PSA Anxiety and Fear of Progression). RESULTS Of the 115 men on AS, 39 enrolled in the stress reduction intervention. No statistically significant differences were observed over time between those who enrolled and those who did not. Next we compared intervention (n=21) vs. control (n=18), in terms of change over time for the three anxiety scores. No between-group difference was found for PC Anxiety (p=0.683) and PSA Anxiety (p=0.423), however there was for Fear of Progression (p=0.043). No difference was found between groups at enrollment, but at month 6 and month 12, intervention participants scores were significantly lower (Bonferroni adjusted p=0.033 and 0.025, respectively). Fear of progression remained constant in control from month 0 to month 6 and 12, but in intervention, this score significantly dropped at month 6 (adj. p=0.048) and month 12 (adj. p=0.018). Large effect sizes appeared at month 6 (1.04) and 12 (1.09), comparing intervention and control. CONCLUSIONS This study provides evidence of an intervention effect, in terms of reducing fear of progression over time. This intervention can provide important skills to manage stress and uncertainty related to PC and AS. Given the small sample size, no covariate effects were assessed at this phase, therefore, larger scale studies are needed to examine these effects and whether adherence to AS may be strengthened for those to whom it is clinically indicated.
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