OBJECTIVE Cancer-specific psychological interventions like cognitive behavioral stress management (CBSM) demonstrate distress (e.g., anxiety/depression) and quality of life (QoL) benefits. Digital formats can expand access. METHOD Patients (80.6% female; 76.5% White; 25-80 years) with Stage I-III cancer and elevated anxiety within 6 months of treatment (surgery/chemotherapy/radiation/immunotherapy) receipt were randomized 1:1 to a 10-module CBSM or health education control digital app and completed questionnaires at Weeks 0, 4, 8, 12. Primary outcomes of greater group-level anxiety (PROMIS-A) and depression symptom (PROMIS-D) reductions for CBSM were met and published; this secondary report evaluates individual-level response results for these outcomes and outcomes beyond anxiety and depression. Chi-square tests compared responder proportions using PROMIS-A/PROMIS-D symptom categories and two levels (≥5/≥7.5) of T-score point reductions. Changes across conditions over time for stress (Perceived Stress Scale), cancer-specific distress (Impact of Event Scale-Intrusions), and QoL (Functional Assessment of Cancer Therapy-General) were analyzed using repeated measures linear mixed-effects modeling (N = 449). Patient Global Impression of Change-Well-being was also examined. RESULTS At Week 12, a greater proportion of CBSM (vs. control) participants reported normal-to-mild (vs. moderate-to-severe) PROMIS-A and PROMIS-D, and a greater proportion of CBSM participants at Week 8 or 12 had a ≥7.5 T-score reduction in PROMIS-A and a ≥5 T-score reduction in PROMIS-D (ps < .05). CBSM participants (vs. control) showed significantly greater reductions in Perceived Stress Scale and Impact of Event Scale-Intrusions and increases in Patient Global Impression of Change-Well-being and Functional Assessment of Cancer Therapy emotional and physical well-being (ps < .05), but not functional or social/family well-being. CONCLUSION Digitized CBSM benefits distress and QoL. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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认知行为数字治疗对癌症患者痛苦和生活质量的影响：全国随机对照试验。


目的 针对癌症的心理干预，如认知行为压力管理 （CBSM），显示出痛苦（例如焦虑/抑郁）和生活质量 （QoL） 的好处。数字格式可以扩展访问范围。方法 接受治疗（手术/化疗/放疗/免疫疗法）后 6 个月内患有 I-III 期癌症且焦虑加剧的患者（80.6% 为女性;76.5% 为白人;25-80 岁）以 1：1 的比例随机分配到 10 模块 CBSM 或健康教育控制数字应用程序，并在第 0、4、8、12 周完成问卷调查。CBSM 的更大群体水平焦虑 （PROMIS-A） 和抑郁症状 （PROMIS-D） 减少的主要结局得到满足并发表;这份次要报告评估了这些结果以及焦虑和抑郁以外的结果的个体水平反应结果。卡方检验使用 PROMIS-A/PROMIS-D 症状类别和两个水平 （≥5/≥7.5） 的 T 分数降低比较了反应者比例。使用重复测量线性混合效应模型 （N = 449） 分析压力 （感知压力量表） 、癌症特异性痛苦 （事件量表入侵的影响） 和 QoL （癌症治疗功能评估 - 一般） 随时间的变化。还检查了患者对变化-健康的总体印象。结果在第 12 周时，更大比例的 CBSM（与对照组相比）参与者报告正常至轻度（与中度至重度）PROMIS-A 和 PROMIS-D，在第 8 周或第 12 周时，更大比例的 CBSM 参与者的 PROMIS-A T 评分降低 ≥7.5，PROMIS-D T 评分降低 ≥5 （ps < .05）。CBSM 参与者（vs. 对照）显示感知压力量表和事件量表干扰的影响显著降低，患者对变化的总体印象-幸福感和癌症治疗情绪和身体健康的功能评估增加 （ps < .05），但没有功能或社会/家庭幸福感。结论 数字化 CBSM 有利于痛苦和 QoL。（PsycInfo 数据库记录 （c） 2024 APA，保留所有权利）。