Dyadic psychosocial intervention for advanced lung cancer patients and their family caregivers: results of a randomized pilot trial.
Dyadic psychosocial intervention for advanced lung cancer patients and their family caregivers: results of a randomized pilot trial.
复制标题
DOI：
10.1002/cncr.29009
复制
发表时间：
2015-01-01
期刊：
影响因子：
6.2
通讯作者：
Redd, William H.
中科院分区：
文献类型：
--
作者：
Badr, Hoda;Smith, Cardinale B.;Goldstein, Nathan E.;Gomez, Jorge E.;Redd, William H.
关键词：
晚期肺癌（LC）患者及其家属报告自我护理/照顾的自我效能低，痛苦率高，但很少有方案可以满足他们在治疗期间的支持性护理需求。本初步研究考察了我们为晚期LC患者及其护理人员开发的6期电话双重心理社会干预的可行性、可接受性和初步疗效。该计划以自我决定理论（SDT）为基础，强调能力（自我效能），自主性（选择/意志感）和相关性（归属感/联系感）对心理功能的重要性。主要结局是心理功能（抑郁/焦虑）和照顾者负担。次要结果是能力、自主性和相关性的SDT构念。39名在治疗开始一个月内（基线）的晚期LC患者及其照顾者（51%的配偶/伴侣）完成了调查，并随机分配到干预组或常规医疗组。8周后，他们完成了随访调查。稳定的招聘（60%）和低流失率证明了可行性。强有力的项目评估（X =8.6 / 10）和作业完成率（88%）支持可接受性。与常规医疗护理相比，接受干预的参与者在抑郁、焦虑和照顾者负担方面有显著改善（p< 0.0001）。在患者和护理人员的能力和关系以及护理人员提供护理的自主动机方面，也发现了支持干预的大效应量（d>1.2）。这些发现支持干预的可行性、可接受性和初步疗效。通过使家庭具备协调护理和共同应对LC挑战的技能，这种干预措施有望改善癌症的姑息/支持性护理服务。
Advanced lung cancer (LC) patients and their families report low self-efficacy for self-care/caregiving and high rates of distress, yet few programs exist to address their supportive care needs during treatment. This pilot study examined the feasibility, acceptability, and preliminary efficacy of a 6-session telephone-based dyadic psychosocial intervention that we developed for advanced LC patients and their caregivers. The program is grounded by Self-determination Theory (SDT), which emphasizes the importance of competence (self-efficacy), autonomy (sense of choice/volition), and relatedness (sense of belonging/connection) for psychological functioning. Primary outcomes were psychological functioning (depression/anxiety) and caregiver burden. Secondary outcomes were the SDT constructs of competence, autonomy, and relatedness. Thirty-nine advanced LC patients who were within one month of treatment initiation (baseline) and their caregivers (51% spouses/partners) completed surveys and were randomized to the intervention or usual medical care. Eight weeks post-baseline, they completed follow-up surveys. Solid recruitment (60%) and low attrition rates demonstrated feasibility. Strong program evaluations (X̄=8.6 out of 10) and homework completion rates (88%) supported acceptability. Participants receiving intervention evidenced significant (p<.0001) improvements in depression, anxiety, and caregiver burden relative to usual medical care. Large effect sizes (d>1.2) favoring the intervention were also found for patient and caregiver competence and relatedness, and for caregiver autonomous motivation for providing care. These findings support intervention feasibility, acceptability, and preliminary efficacy. By empowering families with skills to coordinate care and meet the challenges of LC together, this intervention holds great promise for improving palliative/supportive care services in cancer.
登录
查看更多内容
影响因子：
3.3
作者：
Freedland KE;Mohr DC;Davidson KW;Schwartz JE
通讯作者：
Schwartz JE
影响因子：
3.6
作者：
Badr, Hoda;Taylor, Cindy L. Carmack
通讯作者：
Taylor, Cindy L. Carmack
影响因子：
7.4
作者：
Porter, Laura S.;Keefe, Francis J.;Baucom, Donald
通讯作者：
Baucom, Donald
影响因子：
2.4
作者：
Levesque, Chantal S.;Williams, Geoffrey C.;Finley, Phillip J.
通讯作者：
Finley, Phillip J.
影响因子：
4.7
作者：
Hudson, PL;Aranda, S;Hayman-White, K
通讯作者：
Hayman-White, K