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Does expectancy affect insomnia treatment response in cancer survivors receiving acupuncture and cognitive behavioral therapy?
Li, Xiaotong; Bao, Ting; Garland, Sheila N; Li, Susan Q; Yu, Jennifer; Li, Yuelin; Mao, Jun J.
Afiliação
  • Li X; Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 East 61st Street, 4th Floor, New York, NY, 10065, USA.
  • Bao T; Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 East 61st Street, 4th Floor, New York, NY, 10065, USA.
  • Garland SN; Departments of Psychology and Oncology, Memorial University of Newfoundland, 232 Elizabeth Avenue, St. John's, St. John's, Newfoundland and Labrador, A1B 3X9, Canada.
  • Li SQ; Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 East 61st Street, 4th Floor, New York, NY, 10065, USA.
  • Yu J; Clinical Tinking, Nucleus Global, 300 American Metro Boulevard, Suite 140, Hamilton, New Jersey, NY, 08619, USA.
  • Li Y; Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
  • Mao JJ; Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 East 61st Street, 4th Floor, New York, NY, 10065, USA. maoj@mskcc.org.
J Cancer Surviv ; 17(3): 826-835, 2023 06.
Article em En | MEDLINE | ID: mdl-36462115
PURPOSE: Insomnia negatively affects quality of life in cancer survivors. Expectations of insomnia treatment efficacy may influence response to intervention. We sought to determine whether pre-treatment outcome expectancy predicts response to two non-pharmacological interventions for insomnia among cancer survivors. METHODS: We analyzed data from a randomized clinical trial that compared acupuncture versus cognitive behavioral therapy for insomnia (CBT-I) in cancer survivors. Patient expectancy was measured by the Mao Treatment Expectancy Scale (MTES) at baseline. Insomnia severity was assessed using the Insomnia Severity Index (ISI) at treatment completion (week 8). Multivariate linear regression was used to evaluate the associations between pre-treatment expectancy and ISI score at week, 8 adjusting for co-variates. RESULTS: Expectancy for acupuncture and CBT-I were similar at baseline (acupuncture: 13.3 ± 4.0; CBT-I: 13.2 ± 2.9, p = 0.17). Greater baseline expectancy scores were associated with a greater and statistically significant insomnia severity reduction at week 8 in the acupuncture group (beta coefficients [Coef.] = - 0.35, 95% confidence interval [CI] = - 0.6 to - 0.1, p = 0.016) adjusted for co-variates. Baseline expectancy was not statistically associated with insomnia severity reduction in the CBT-I group (Coef. = - 0.2, 95% CI = - 0.7 to 0.2, p = 0.31). High expectancy was significantly associated with greater proportion of treatment responders at week 8 in the acupuncture group (76% vs. 38%, p = 0.001) but not in the CBT-I group (83% vs. 70%, p = 0.21). CONCLUSIONS: Higher pre-treatment outcome expectancy predicted significantly greater insomnia improvement in patients receiving acupuncture but not in those receiving CBT-I. IMPLICATIONS FOR CANCER SURVIVORS: Aligning treatment provision with expected outcomes may lead to personalized non-pharmacological insomnia management for cancer survivors.
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Texto completo: 1 Base de dados: MEDLINE Medicinas Tradicionais: Medicinas_tradicionales_de_asia / Medicina_china Métodos Terapêuticos e Terapias MTCI: Terapias_manuales Assunto principal: Terapia por Acupuntura / Terapia Cognitivo-Comportamental / Sobreviventes de Câncer / Distúrbios do Início e da Manutenção do Sono / Neoplasias Tipo de estudo: Clinical_trials / Prognostic_studies Idioma: En Revista: J Cancer Surviv Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Base de dados: MEDLINE Medicinas Tradicionais: Medicinas_tradicionales_de_asia / Medicina_china Métodos Terapêuticos e Terapias MTCI: Terapias_manuales Assunto principal: Terapia por Acupuntura / Terapia Cognitivo-Comportamental / Sobreviventes de Câncer / Distúrbios do Início e da Manutenção do Sono / Neoplasias Tipo de estudo: Clinical_trials / Prognostic_studies Idioma: En Revista: J Cancer Surviv Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos