Caregiver-guided pain coping skills training for patients with advanced cancer: Results from a randomized clinical trial.
Caregiver-guided pain coping skills training for patients with advanced cancer: Results from a randomized clinical trial.
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晚期癌症患者由护理员指导的疼痛应对技能培训：随机临床试验的结果。
DOI：
10.1177/02692163211004216
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发表时间：
2021-05
影响因子：
4.4
通讯作者：
Keefe FJ
中科院分区：
文献类型：
--
作者：
Porter LS;Steel JL;Fairclough DL;LeBlanc TW;Bull J;Hanson LC;Fischer S;Keefe FJ
疼痛是晚期癌症患者及其家人照顾者的主要担忧。有证据表明，疼痛应对技能培训干预措施可以改善结果，但很少在这一人群中进行测试。目的：测试护理员指导的疼痛应对技能培训干预的效果。主要结果是护理者帮助患者控制疼痛的自我效能感。一项随机对照试验将干预与强化照常治疗对照进行了比较。在两种情况下，双胞胎都接受了疼痛教育，而干预组接受了三次疼痛应对技能培训。在基线和干预后收集照顾者结果(自我效能；照顾者压力、照顾者满意度、心理痛苦)和患者结果(自我效能、疼痛强度和干预、心理痛苦)。202名III-IV期癌症和疼痛患者及其家庭照顾者来自四个肿瘤科门诊诊所和一个独立的临终关怀/姑息治疗组织。与对照组相比，干预组中的照顾者报告在照看满意度(p<；.01)和降低焦虑(p=.04)方面有显著提高。在这两种情况下，照顾者报告自我效能有所改善，患者报告自我效能、疼痛严重程度和干预以及心理困扰方面的改善。这是第一项针对晚期癌症患者和照顾者测试疼痛应对技能干预的研究。研究结果表明，疼痛教育为患者和照顾者提供了好处，应对技能培训可能对照顾者有利。需要进一步的研究来优化教育和疼痛应对技能培训的好处，以改善癌症疼痛的结果。
Pain is a major concern among patients with advanced cancer and their family caregivers. Evidence suggests that pain coping skills training interventions can improve outcomes, however they have rarely been tested in this population. To test the efficacy of a caregiver-guided pain coping skills training intervention. The primary outcome was caregiver self-efficacy for helping the patient manage pain. A randomized controlled trial compared the intervention to an enhanced treatment-as-usual control. Dyads in both conditions received pain education, and those in the intervention received three sessions of pain coping skills training. Caregiver outcomes (self-efficacy; caregiver strain, caregiving satisfaction, psychological distress) and patient outcomes (self-efficacy, pain intensity and interference, psychological distress) were collected at baseline and post-intervention. 202 patients with stage III-IV cancer and pain and their family caregivers were enrolled from four outpatient oncology clinics and a free-standing hospice/palliative care organization. Compared to those in the control arm, caregivers in the intervention reported significant increases in caregiving satisfaction (p<.01) and decreased anxiety (p=.04). In both conditions, caregivers reported improvements in self-efficacy, and patients reported improvements in self-efficacy, pain severity and interference, and psychological distress. This is the first study to test a pain coping skills intervention targeted to patients and caregivers facing advanced cancer. Findings suggest that pain education provides benefits for patients and caregivers, and coping skills training may be beneficial for caregivers. Further research is needed to optimize the benefits of education and pain coping skills training for improving cancer pain outcomes.
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DOI：
10.1093/geronj/44.3.p61
发表时间：
1989-05-01
期刊：
JOURNALS OF GERONTOLOGY
影响因子：
--
作者：
LAWTON, MP;KLEBAN, MH;GLICKSMAN, A
通讯作者：
GLICKSMAN, A
影响因子：
5.4
作者：
Hodges, LJ;Humphris, GM;Macfarlane, G
通讯作者：
Macfarlane, G
影响因子：
7
作者：
CARROLL, BT;KATHOL, RG;CLAMON, GH
通讯作者：
CLAMON, GH
影响因子：
4.7
作者：
Currow, David C.;Plummer, John L.;Abernethy, Amy P.
通讯作者：
Abernethy, Amy P.
影响因子：
4.7
作者：
Porter, Laura S.;Keefe, Francis J.;Scipio, Cindy
通讯作者：
Scipio, Cindy