The meaning of life intervention for patients with advanced-stage cancer: development and pilot study.
The meaning of life intervention for patients with advanced-stage cancer: development and pilot study.
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DOI：
10.1188/12.onf.e480-e488
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发表时间：
2012-11-01
影响因子：
1.9
通讯作者：
Ching, Shirley
中科院分区：
文献类型：
--
作者：
Mok, Esther;Lau, Ka-po;Ching, Shirley
目的/目的：发展生命意义干预，以响应姑息治疗中对简短和以意义为中心的干预的需求，并为未来的全面随机对照试验建立潜在的效应量。设计：一项随机对照试验，旨在对生命意义干预进行先导测试。地点：香港一所城市急症综合医院设有68张床位的肿瘤住院病房。样本：84例晚期癌症患者。58人完成了这项研究。方法：在基线、干预后1天和2周对结果变量进行评估。患者随机分为干预组和对照组。采用重复测量协方差分析来评估生命意义干预对参与者生活质量的影响。主要研究变量：主要结果是生活质量，并通过生命末期生活质量（QOLC-E）问卷和单项目全球生活质量量表来测量。QOLC-E的8个分量表作为次要指标。结果：组在QOLC-E问卷总分、整体生活质量单项量表和QOLC-E问卷存在困扰子量表上均有统计学显著的主效应。这些效应表现为中等效应。结论：本初步研究结果显示，生命意义干预可以改善患者的生活质量，尤其是存在焦虑。对护理的启示：生命的意义干预代表了一种潜在的有效和高效的干预，可以由护理人员在姑息治疗环境中对晚期癌症患者实施。
PURPOSE/OBJECTIVES: To develop the Meaning of Life Intervention in response to the need for brief and meaning-focused interventions in palliative care and to establish potential effect sizes for future full-scale randomized, controlled trials.DESIGN: A randomized, controlled trial conducted to pilot test the Meaning of Life Intervention.SETTING: A 68-bed oncology inpatient ward in an urban acute general hospital in Hong Kong.SAMPLE: 84 patients with advanced-stage cancer. Fifty-eight completed the study.METHODS: Assessments of outcome variables were conducted at baseline and one day and two weeks after the intervention. Patients were randomly allocated to the intervention group or the control group. Repeated measures analysis of covariance were conducted to assess the impact of the Meaning of Life Intervention on participants' quality of life.MAIN RESEARCH VARIABLES: The primary outcome was quality of life and was measured by the Quality-of-Life Concerns in the End-of-Life (QOLC-E) questionnaire and with a single-item scale on global quality of life. The eight subscales of the QOLC-E served as secondary outcomes.FINDINGS: Statistically significant main effects were noted for the group in the QOLC-E questionnaire total score, the single-item scale on global quality of life, and the existential distress subscale of the QOLC-E questionnaire. The effects represented a medium effect size.CONCLUSIONS: The results of this pilot study show that the Meaning of Life Intervention can improve quality of life, particularly existential distress.IMPLICATIONS FOR NURSING: The Meaning of Life Intervention represents a potentially effective and efficient intervention that is feasible for implementation by nursing staff for patients with advanced-stage cancer in a palliative care setting.