A novel combined resilience and advance care planning intervention for adolescents and young adults with advanced cancer: A feasibility and acceptability cohort study.
A novel combined resilience and advance care planning intervention for adolescents and young adults with advanced cancer: A feasibility and acceptability cohort study.
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DOI：
10.1002/cncr.33830
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发表时间：
2021-12-01
期刊：
影响因子：
6.2
通讯作者：
Rosenberg, Abby R.
中科院分区：
文献类型：
--
作者：
Fladeboe, Kaitlyn M.;O'Donnell, Maeve B.;Barton, Krysta S.;Bradford, Miranda C.;Steineck, Angela;Junkins, Courtney C.;Yi-Frazier, Joyce P.;Rosenberg, Abby R.
关键词：
很少有循证社会心理计划在患有晚期癌症的青少年和年轻人（AYA）中进行了测试，并且在该人群中很少进行早期预先护理计划（ACP）。
合格的AYA为12至24岁，被诊断出患有晚期癌症（复发/难治性疾病或与<50％的生存率相关的诊断），并流利地促进压力管理癌症（PRISM-AC）计划的恢复能力。涉及我的选择ACP指南的元素在基准和12周内完成了调查，并在研究完成后将其退出访谈。描述性检查。
在符合条件的50个符合条件的情况下，AYA的26个（52％）的基线调查的平均年龄为16岁（SD = 2.7年），男性是男性（73％）（73％） ％将整体和ACP计划描述为有价值，焦虑，抑郁和希望之后不变。
弹性的辅导辅导是可行的，并且可以接受AC的AYA。
青少年和年轻人（AYA）患有晚期癌症的预先护理计划（ACP）可能很难引入。
我们研究了将ACP集成到AYA的现有弹性教练计划中是否可行和接受。
在这项对26个AYA患有晚期癌症的队列研究中，我们发现可行的压力管理 - 癌症计划的弹性是可行的（≥70％的干预完成）和高度可接受的（促进后反馈的阳性，没有参与者参与者参与者）。
我们包括一项整合弹性教练和ACP的干预措施在患有晚期癌症的AYA中是可行的，并且可以接受。
Few evidence-based psychosocial programs have been tested among adolescents and young adults (AYAs) with advanced cancer (AC), and early advance care planning (ACP) in this population is rare. The authors aimed to determine the feasibility and acceptability of 1) delivering an established resilience-coaching program, and 2) integrating ACP into that program, among AYAs with AC. Eligible AYAs were 12 to 24 years old, diagnosed with advanced cancer (recurrent/refractory disease or a diagnosis associated with <50% survival) and fluent in English. The Promoting Resilience in Stress Management–Advanced Cancer (PRISM-AC) program included PRISM’s standard sessions targeting stress-management, goal-setting, cognitive-restructuring, and meaning-making, delivered 1:1, 1 to 2 weeks apart, plus a new session involving elements of the AYA-specific Voicing My Choices ACP guide. Participants completed surveys at baseline and 12 weeks, and exit interviews following study completion. Feasibility was defined as ≥70% completion of 1) standard 4-session PRISM and 2) the new ACP session among those completing standard PRISM. Acceptability was defined qualitatively. Trajectories of patient-reported anxiety, depression, and hope were examined descriptively. Of 50 eligible, approached AYAs, 26 (52%) enrolled and completed baseline surveys. The AYAs had a mean age of 16 years (SD = 2.7 years), and the majority were male (73%) and White/Caucasian (62%). Twenty-two AYAs (85%) completed standard PRISM, and of those, 18 (82%) completed the ACP session. Feedback was highly positive; 100% and 91% described the overall and ACP programs as valuable, respectively. Anxiety, depression, and hope were unchanged after the program. Resilience coaching followed by integrated ACP is feasible and acceptable for AYAs with AC. Participating did not cause distress or decrease hope. Advance care planning (ACP) among adolescents and young adults (AYAs) with advanced cancer can be difficult to introduce. We investigated whether it is feasible and acceptable to integrate ACP into an existing resilience-coaching program for AYAs. In this cohort study of 26 AYAs with advanced cancer, we found the Promoting Resilience in Stress Management–Advanced Cancer program to be feasible (≥70% intervention-completion) and highly acceptable (positive post-participation feedback, no evidence of participant-distress). We conclude that an intervention integrating resilience coaching and ACP is feasible and acceptable among AYAs with advanced cancer.
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