Caregiver-Assisted Coping Skills Training for Lung Cancer: Results of a Randomized Clinical Trial
Caregiver-Assisted Coping Skills Training for Lung Cancer: Results of a Randomized Clinical Trial
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DOI：
10.1016/j.jpainsymman.2010.04.014
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发表时间：
2011-01-01
影响因子：
4.7
通讯作者：
Scipio, Cindy
中科院分区：
文献类型：
--
作者：
Porter, Laura S.;Keefe, Francis J.;Scipio, Cindy
上下文肺癌是美国最常见的癌症之一，与高水平的症状有关，包括疼痛，疲劳，呼吸急促和心理困扰。护理人员和患者受到不利影响。然而，以前的研究应对技能训练（CST）干预措施没有在肺癌患者中进行测试，也没有系统地包括肺癌患者。本研究在肺癌患者样本中测试了一种经皮穿刺辅助CST方案的有效性。233例肺癌患者和他们的照顾者被随机分配接受14次电话会议，无论是治疗者辅助CST或教育/支持涉及照顾者。患者完成评估疼痛，心理困扰，生活质量（QOL），和自我效能的症状管理的措施;照顾者完成评估心理困扰，照顾者的压力，和自我效能的措施，帮助患者管理myself。两种治疗条件下的患者在疼痛，抑郁，QOL和自我效能方面都有所改善，两种条件下的护理人员从基线到4个月随访时的焦虑和自我效能都有所改善。探索性分析结果表明，CST干预对II期和III期癌症患者/照顾者更有益，而教育/支持干预对I期癌症患者/照顾者更有益。结合这一领域更广泛的文献，本研究的结果表明，心理社会干预可以改善癌症患者的一系列预后。对未来研究的建议包括使用三组设计（例如，将两种积极干预措施与标准护理对照进行比较），并检查变化机制。J Pain Symptom Manage 2011;41：1-13. (C)2011年美国癌症疼痛缓解委员会。爱思唯尔公司出版All rights reserved.
Context. Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms, including pain, fatigue, shortness of breath, and psychological distress. Caregivers and patients are adversely affected. However, previous studies of coping skills training (CST) interventions have not been tested in patients with lung cancer nor have systematically included caregivers.Objectives. This study tested the efficacy of a caregiver-assisted CST protocol in a sample of patients with lung cancer.Methods. Two hundred thirty-three lung cancer patients and their caregivers were randomly assigned to receive 14 telephone-based sessions of either caregiver-assisted CST or education/support involving the caregiver. Patients completed measures assessing pain, psychological distress, quality of life (QOL), and self-efficacy for symptom management; caregivers completed measures assessing psychological distress, caregiver strain, and self-efficacy for helping the patient manage symptoms.Results. Patients in both treatment conditions showed improvements in pain, depression, QOL, and self-efficacy, and caregivers in both conditions showed improvements in anxiety and self-efficacy from baseline to four-month follow-up. Results of exploratory analyses suggested that the CST intervention was more beneficial to patients/caregivers with Stage II and III cancers, whereas the education/support intervention was more beneficial to patients/caregivers with Stage I cancer.Conclusion. Taken together with the broader literature in this area, results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients. Suggestions for future studies include the use of three-group designs (e.g., comparing two active interventions with a standard-care control) and examining mechanisms of change. J Pain Symptom Manage 2011;41:1-13. (C) 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.