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Construction and Preliminary Evaluation of Dyadic Acceptance and Commitment Therapy for Couples With Fear of Lung Cancer Recurrence

2026年5月15日 更新者:Feifei Huang

The goal of this clinical trial is to develop a simple, scientific, effective, and culturally adapted dyadic Acceptance and Commitment Therapy (ACT) intervention program (the ADAPT program) targeting fear of cancer recurrence (FCR) among lung cancer patients and their spouse caregivers. The study will also evaluate the feasibility, acceptability, and preliminary effectiveness of the ADAPT program.

The main research questions are as follows:

  • Is the ADAPT intervention program feasible and acceptable for lung cancer patients and their spouse caregivers?
  • Compared with usual care, can the ADAPT intervention program preliminarily reduce FCR levels in both patients and their spouse caregivers? Can the program improve coping styles, illness perceptions, family functioning, and intimate relationships among both patients and their spouse caregivers? Can the program enhance psychological flexibility and quality of life (QOL) in both patients and their spouse caregivers? Researchers will compare the ADAPT intervention program with usual care to evaluate its preliminary effectiveness in reducing FCR among lung cancer patients and their spouse caregivers.

Participants will:

  • Receive the ADAPT intervention twice during each radiotherapy and/or chemotherapy cycle, for a total of three treatment cycles (approximately 3 months);
  • Complete questionnaires at baseline (before the intervention), immediately after the intervention, and one month post-intervention;
  • Report outcomes including FCR severity, FCR triggers, psychological flexibility, illness perception, dyadic coping, family functioning, intimacy, and quality of life (QOL).

調査の概要

研究の種類

介入

入学 (推定)

72

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

  • 名前:Feifei Huang, Ph. D
  • 電話番号:+86 13763869099
  • メール:pt860315@163.com

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

説明

Inclusion Criteria

Patients:

  • Diagnosis of primary lung cancer confirmed by pathological examination.
  • Age ≥ 22 years for men and ≥ 20 years for women (legal marriage age in China).
  • Have undergone lung cancer surgery and are scheduled to receive the first round of radiotherapy and/or chemotherapy treatment
  • Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF) score ≥ 13, indicating moderate-to-severe FCR.
  • Eastern Cooperative Oncology Group (ECOG) ≤2.
  • Aware of their diagnosis and willing to participate voluntarily.
  • Normal cognitive function (Montreal Cognitive Assessment [MoCA] score ≥ 26), alert and conscious, and able and willing to communicate their thoughts.

Spouse Caregivers:

  • Identified by the patient as the primary caregiver, providing ≥ 50% of care in the past 2 weeks.
  • Legally married to the patient.
  • Age ≥ 22 years for men and ≥ 20 years for women.
  • Normal cognitive function (MoCA score ≥ 26), no diagnosed mental disorders, able to communicate effectively, and willing to share their thoughts.

Exclusion Criteria

Patients:

  • Diagnosed mental disorders or currently receiving psychiatric treatment.
  • Presence of personality disorders, intellectual disability, memory disorders, brain injury, or neurological disease.
  • Concurrent malignant tumors in other organs.
  • Severe complications (e.g., chest pain and/or dyspnea due to pleural tumor invasion).
  • Spouse caregiver unwilling to participate.
  • History of upper limb fractures or surgery resulting in impaired hand function.
  • Participation in other similar psychological interventions.

Spouse Caregivers:

  • Presence of serious comorbid conditions (e.g., respiratory failure, malignant tumors, or other critical illnesses).
  • Patient unwilling to participate.
  • Participation in other research studies.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:支持療法
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:独身

武器と介入

参加者グループ / アーム
介入・治療
実験的:介入群

In addition to routine care provided to the control group, the ACT intervention will be delivered by researchers who have completed formal training in Acceptance and Commitment Therapy (ACT). The intervention will be conducted in a quiet and comfortable demonstration room within the department.

The intervention will be delivered in a face-to-face, couple-based format. It will consist of six sessions, with two sessions per treatment cycle, each lasting 35-75 minutes, over a total of three treatment cycles.

The intervention will incorporate techniques such as metaphor-based exercises, mindful breathing, body scan, the T-puzzle, and the Chinese finger trap.

The preliminary structure is as follows: six fixed in-person sessions (Sessions 1-6), supplemented by online homework assignments completed between sessions.

アクティブコンパレータ:対照群

① Health education:

  1. Disease knowledge education
  2. Nutrition and hygiene education

    • Follow-up management and symptom monitoring: Conduct a telephone follow-up within one month after the patient is discharged from the hospital to ensure timely monitoring of the patient's physical condition.

      • Home rehabilitation management: Provide nutritional counseling services for the patient and spouse caregiver, guide home-based dietary adjustments, and maintain good nutritional status and immunity. Encourage the patient and spouse caregiver to communicate promptly with the medical team when experiencing uncomfortable symptoms, thereby speeding up recovery and improving rehabilitation outcomes.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change from baseline in fear of cancer recurrence severity of lung cancer patients-The Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF)
時間枠:Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
The scale consists of 9 items, each rated from 0 to 4. Zero is equivalent to "never" and 4 indicates "always". Total scores range from 0 to 36, where 0 indicates no fear of cancer recurrence and 36 indicates the highest possible fear. A score of 13 or higher is defined as subclinical fear of cancer recurrence.
Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
Change from baseline in fear of cancer recurrence severity of spouse caregivers-Fear of Cancer Recurrence Inventory Short Form-Caregiver Version (FCRI-SF-C)
時間枠:Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
The scale consists of 9 items, each rated from 0 to 4. Zero is equivalent to "never" and 4 indicates "always". Total scores range from 0 to 36, where 0 indicates no fear of cancer recurrence and 36 indicates the highest possible fear. A score of 13 or higher is defined as subclinical fear of cancer recurrence.
Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)

二次結果の測定

結果測定
メジャーの説明
時間枠
Recruitment Rate: Percentage of Eligible Participants Who Successfully Enroll in the Study Out of All Potentially Eligible Participants Meeting Inclusion/Exclusion Criteria
時間枠:Post-intervention (3 months)
Recruitment rate is calculated as (number of eligible participants who successfully enroll in the study / total number of potentially eligible participants meeting all inclusion and none of the exclusion criteria) × 100%. The rate ranges from 0% to 100%, with a higher rate indicating better recruitment efficiency.
Post-intervention (3 months)
Consent Compliance Rate: Percentage of Participants Who Sign Informed Consent Among Those Who Meet Inclusion Criteria
時間枠:Post-intervention (3 months)
Consent compliance rate is calculated as (number of participants who sign the informed consent form / total number of participants who meet the predefined inclusion criteria) × 100%. The rate ranges from 0% to 100%.
Post-intervention (3 months)
Participation Rate: Percentage of Randomized Participants Who Completed All Intervention Sessions
時間枠:Post-intervention (3 months)
Participation rate is calculated as (number of participants who completed all intervention sessions / total number of participants randomized) × 100%. The rate ranges from 0% to 100%.
Post-intervention (3 months)
Withdrawal Rate: Percentage of Initially Enrolled Participants Who Voluntarily Withdraw or Are Lost to Follow-Up
時間枠:Post-intervention (3 months)
Withdrawal rate is calculated as (number of participants who voluntarily withdraw from the study or are lost to follow-up after enrollment / total number of participants initially enrolled) × 100%. The rate ranges from 0% to 100%.
Post-intervention (3 months)
Number of Participants with Study-Related Adverse Events as Assessed by CTCAE v4.0
時間枠:Intervene in the whole process (3 months)
The study uses a self-developed Adverse Event Form to document study-related adverse events (AEs) occurring during the study period. The incidence rate is calculated as (number of participants experiencing at least one study-related AE / total number of enrolled participants) × 100%. Severity grading follows the CTCAE v4.0.
Intervene in the whole process (3 months)
Satisfaction with the Intervention Program as Assessed by Qualitative Interviews
時間枠:Post-intervention (3 months)
Semi-structured interviews are conducted by the investigator using a final interview guide developed through group brainstorming and revised by a nursing professor experienced in qualitative research. Sampling continues until no new themes emerge and meaning saturation is achieved. Thematic analysis is used to identify satisfaction-related patterns, and findings are reported with representative quotes. No predefined numeric threshold is applied.
Post-intervention (3 months)
Change from baseline in fear of cancer recurrence triggering factors-The Fear of Cancer Recurrence Inventory-Triggering factors (FCRI-T)
時間枠:Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
This 8-item dimension assesses how often daily triggers elicit fear of cancer recurrence. Each item is scored from 0 to 4. Zero is equivalent to "never" and 4 indicates "always". Total scores range from 0 to 32, where 0 indicates that none of the factors trigger fear and 32 indicates that all factors always trigger fear.
Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
Change from baseline in psychological flexibility-Comprehensive Assessment of ACT Processes (CompACT)
時間枠:Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
The CompACT contains 22 items, each scored from 0 to 6. Zero is equivalent to "never" and 6 indicates "always". After reverse-scoring the values and committed action domain (plus four items of the mindfulness and self-as-context domain), total scores range from 0 to 132, where 0 indicates the lowest possible psychological flexibility and 132 indicates the highest possible psychological flexibility.
Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
Change from baseline in illness perception-Brief Illness Perception Questionnaire (B-IPQ)
時間枠:Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
The B-IPQ includes 8 items, each scored from 0 to 10. Zero is equivalent to "no perception of that aspect" and 10 indicates "extreme perception of that aspect". Total scores range from 0 to 80, where 0 indicates a very benign illness perception and 80 indicates the most threatening illness perception possible. The ninth open-ended item asks participants to list the three most important causal factors.
Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
Change from baseline in dyadic coping-Dyadic Coping Inventory (DCI)
時間枠:Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
The DCI consists of 37 items, each rated from 1 to 5. One is equivalent to "very rarely" and 5 indicates "very frequently". Total scores range from 35 to 75, where 35 indicates the lowest possible dyadic coping competence and 75 indicates the highest possible dyadic coping competence.
Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
Change from baseline in intimate relationship-Unidimensional Relationship Closeness Scale (URCS)
時間枠:Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
This 11-item scale uses a 5-point scale from 1 to 5. 1 is equivalent to "strongly disagree" and 5 indicates "strongly agree". The mean of all item scores is calculated, ranging from 1 to 5, where 1 indicates the lowest perceived closeness and 5 indicates the highest perceived closeness.
Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
Change from baseline in family care-Family Adaptation, Partnership, Growth, Affection, Resolve index Questionnaire (Family APGAR Questionnaire)
時間枠:Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
The Family APGAR has 5 items, each scored from 0 to 2. Zero is equivalent to "hardly ever" and 2 indicates "almost always". Total scores range from 0 to 10, where 0 indicates the poorest family function and 10 indicates the best family function. Scores of 7-10 indicate good family function, 4-6 moderate dysfunction, and 0-3 severe dysfunction.
Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
Change from baseline in quality of life of lung cancer patients-Functional Assessment of Cancer Therapy (FACT-L V4.0)
時間枠:Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
The FACT-L V4.0 consists of 36 items. Each item is scored from 0 to 4. Zero is equivalent to "not at all" and 4 indicates "very much". Positively worded items are scored 0-4; reverse-worded items are scored 4-0. The total score is the sum of five dimension scores (physical, social/family, emotional, functional, and lung-specific), ranging from 0 to 144, where 0 indicates the poorest possible quality of life and 144 indicates the best possible quality of life.
Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
Change from baseline in quality of life of spouse caregivers-The 12-item short from healthy survey (SF-12)
時間枠:Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)
The SF-12 includes 12 items covering eight dimensions. Items 1,8,9,10 are reverse-scored. Standardized scores for the PCS and MCS each range from 0 to 100, where 0 indicates the worst possible quality of life and 100 indicates the best possible quality of life.
Baseline, after the third intervention (1.5 months), post-intervention (3 months), 1 month after intervention (4 months)

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • スタディディレクター:Feifei Huang, Ph. D、Fujian Medical University

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年5月15日

一次修了 (推定)

2027年6月30日

研究の完了 (推定)

2027年6月30日

試験登録日

最初に提出

2026年5月4日

QC基準を満たした最初の提出物

2026年5月10日

最初の投稿 (実際)

2026年5月14日

学習記録の更新

投稿された最後の更新 (実際)

2026年5月19日

QC基準を満たした最後の更新が送信されました

2026年5月15日

最終確認日

2026年5月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • Ethical Review No. 2 (2026)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

The datasets are not publicly available due privacy reasons but are available from the director upon reasonable request.

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