Implementation of a Psychoeducational Program for Cancer Survivors and Family Caregivers at a Cancer Support Community Affiliate A Pilot Effectiveness Study
Implementation of a Psychoeducational Program for Cancer Survivors and Family Caregivers at a Cancer Support Community Affiliate A Pilot Effectiveness Study
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DOI：
10.1097/ncc.0000000000000311
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发表时间：
2016-05-01
期刊：
影响因子：
2.6
通讯作者：
Northouse, Laurel
中科院分区：
文献类型：
--
作者：
Dockham, Bonnie;Schafenacker, Ann;Northouse, Laurel
背景资料：在随机临床试验中进行有效性测试的心理教育干预措施很少在临床实践中实施，癌症幸存者及其家庭照顾者可以从中受益。目的：本研究探讨了由机构社会工作者在癌症支持社区（CSC）附属机构实施的FOCUS计划对癌症幸存者及其家庭照顾者的效果。研究目的是（1）测试该计划对幸存者和照顾者结果的影响，作为一个单元，（2）确定计划在招募，保留，干预保真度和满意度方面的可行性。方法：对34名癌症幸存者-照顾者进行了干预前和干预后的试点有效性研究。最初由护士在夫妻之家提供的FOCUS方案被修改为小组形式，并由CSC社会工作者提供。主要结局是生活质量（QOL）。中间结果是疾病/康复、沟通、支持和自我效能的益处。分析包括重复测量方差分析。结果：二人组在总生活质量、身体、情感和功能生活质量、疾病益处和自我效能方面均有显著改善。效应量与之前的随机临床试验结果相似。虽然二联体很难招募（登记，60%），保留（92%）和干预保真度（94%）都很高。结论：机构工作人员可以在CSC附属机构实施FOCUS计划，获得积极的干预效果，并保持干预的保真度。对实践的影响：研究人员和临床医生需要合作，在实践环境中为癌症幸存者及其家庭护理人员实施更多基于证据的干预措施。
Background: Psychoeducational interventions, tested for efficacy in randomized clinical trials, are seldom implemented in clinical practice where cancer survivors and their family caregivers can benefit from them. Objective: This study examined the effectiveness of the FOCUS Program on cancer survivors' and their family caregivers' outcomes when implemented at a Cancer Support Community (CSC) affiliate by agency social workers. Study aims were to (1) test effects of the program on survivor and caregiver outcomes as a unit and (2) determine program feasibility in terms of enrollment, retention, intervention fidelity, and satisfaction. Methods: A preintervention and postintervention pilot effectiveness study was conducted with 34 cancer survivor-caregiver dyads (ie, pairs). The FOCUS Program, originally delivered by nurses in dyads' homes, was modified to a small-group format and delivered by CSC social workers. The primary outcome was quality of life (QOL). Intermediary outcomes were benefits of illness/caregiving, communication, support, and self-efficacy. Analyses included repeated-measures analysis of variance. Results: Dyads had significant improvements in total QOL; physical, emotional, and functional QOL; benefits of illness; and self-efficacy. Effect sizes were similar to prior randomized clinical trial findings. Although dyads were difficult to recruit (enrollment, 60%), both retention (92%) and intervention fidelity (94%) were high. Conclusions: It was possible to implement the FOCUS Program at a CSC affiliate by agency staff, obtain positive intervention effects, and maintain intervention fidelity. Implications for Practice: Researchers and clinicians need to collaborate to implement more evidence-based interventions in practice settings for cancer survivors and their family caregivers.