A guided self-help intervention targeting psychological distress among head and neck cancer and lung cancer patients: motivation to start, experiences and perceived outcomes.
A guided self-help intervention targeting psychological distress among head and neck cancer and lung cancer patients: motivation to start, experiences and perceived outcomes.
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DOI：
10.1007/s00520-016-3393-x
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Verdonck-de Leeuw IM
中科院分区：
文献类型：
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作者：
Krebber AH;van Uden-Kraan CF;Melissant HC;Cuijpers P;van Straten A;Becker-Commissaris A;Leemans CR;Verdonck-de Leeuw IM
最近的一项随机临床试验结果表明，针对头颈癌和肺癌患者的心理困扰，指导性自助干预（基于问题解决疗法）是有效的。本研究定性探讨了动机开始，经验和感知的结果，这种干预。数据收集自16名患者的半结构化访谈。所有访谈都进行了录音和逐字记录。数据由两名编码员分别进行分析，并编码为关键问题和主题。患者参与干预的内在原因（例如帮助自己）和外在原因（例如被护理专业人员询问或帮助改善医疗保健）。与会者表示积极和消极的经验与干预。一些与会者赞赏参与是一种愉快的自我工作方式，而其他人则认为参与过于对抗。有些人表示失望，因为他们觉得干预没有给他们带来任何东西，或者表示他们暂时感觉更糟，但大多数参与者认为干预的积极成果（例如，感觉不那么痛苦，并了解了生活中重要的事情）。癌症患者有各种理由开始引导自助干预。参与者赞赏引导自助作为解决心理困扰的干预措施，但也有一些担忧。大多数参与者报告干预是有益的。研究结果表明，需要确定哪些患者可能受益于针对心理困扰的指导性自助，并且干预措施应进一步根据癌症患者的要求进行调整。
Recent results of a randomized clinical trial showed that a guided self-help intervention (based on problem-solving therapy) targeting psychological distress among head and neck cancer and lung cancer patients is effective. This study qualitatively explored motivation to start, experiences with and perceived outcomes of this intervention. Data were collected from semi-structured interviews of 16 patients. All interviews were audio-recorded and transcribed verbatim. Data were analyzed individually by two coders and coded into key issues and themes. Patients participated in the intervention for intrinsic (e.g. to help oneself) and for extrinsic reasons (e.g. being asked by a care professional or to help improve health care). Participants indicated positive and negative experiences with the intervention. Several participants appreciated participating as being a pleasant way to work on oneself, while others described participating as too confrontational. Some expressed their disappointment as they felt the intervention had brought them nothing or indicated that they felt worse temporarily, but most participants perceived positive outcomes of the intervention (e.g. feeling less distressed and having learned what matters in life). Cancer patients have various reasons to start a guided self-help intervention. Participants appreciated the guided self-help as intervention to address psychological distress, but there were also concerns. Most participants reported the intervention to be beneficial. The results suggest the need to identify patients who might benefit most from guided self-help targeting psychological distress and that interventions should be further tailored to individual cancer patients’ requirements.