Is referral of postsurgical colorectal cancer survivors to cardiac rehabilitation feasible and acceptable? A pragmatic pilot randomised controlled trial with embedded qualitative study.
Is referral of postsurgical colorectal cancer survivors to cardiac rehabilitation feasible and acceptable? A pragmatic pilot randomised controlled trial with embedded qualitative study.
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DOI：
10.1136/bmjopen-2015-009284
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发表时间：
2016-01-04
期刊：
影响因子：
2.9
通讯作者：
Watson A
中科院分区：
文献类型：
--
作者：
Hubbard G;Adams R;Campbell A;Kidd L;Leslie SJ;Munro J;Watson A
(1)评估心脏康复（CR）是否是结肠直肠癌（CRC）术后幸存者的一种可行和可接受的康复模式；(2)评估试验程序。本文报告了第一个目标的结果。在英国3家有CR设施的医院进行了一项实用的随机对照试验。描述性统计用于总结指示干预可行性和可接受性的试验参数。进行了访谈和焦点小组，并对数据进行了专题分析。如果CRC患者年龄≥18岁，被诊断为原发性CRC且处于术后恢复期（他们可能仍在接受辅助治疗），则考虑将其纳入试验。31% （n=41）的符合条件的CRC幸存者同意参加试验。22名结直肠癌幸存者、8名心血管疾病患者、5名结直肠癌护士和6名结直肠癌临床医生参与了定性研究。转介术后CRC幸存者每周CR运动课程和信息会议。班级包括结直肠癌幸存者和心血管疾病患者。CR护士和物理治疗师接受了有关癌症和运动的培训。CR的障碍是手术后的长期恢复、持续治疗和活动能力差。试验期间无不良事件报告，表明CR是安全的。62%的参与者按照协议完成了干预，并且出勤率很高。20名卫生专业人员参加了癌症和运动培训课程，被评为优秀。参与者认为CR增加了CRC幸存者的信心和锻炼的动力，并提供同伴支持。CR专业人员关注CR容纳癌症幸存者的能力以及他们为这组患者提供社会心理支持的能力。对于术后结直肠癌幸存者，CR是可行和可接受的。应对干预措施进行大规模的有效性试验。ISRCTN63510637。
(1) Assess whether cardiac rehabilitation (CR) is a feasible and acceptable model of rehabilitation for postsurgical colorectal cancer (CRC) survivors, (2) evaluate trial procedures. This article reports the results of the first objective. A pragmatic pilot randomised controlled trial with embedded qualitative study was conducted in 3 UK hospitals with CR facilities. Descriptive statistics were used to summarise trial parameters indicative of intervention feasibility and acceptability. Interviews and focus groups were conducted and data analysed thematically. People with CRC were considered for inclusion in the trial if they were ≥18 years old, diagnosed with primary CRC and in the recovery period postsurgery (they could still be receiving adjuvant therapy). 31% (n=41) of all eligible CRC survivors consented to participate in the trial. 22 of these CRC survivors, and 8 people with cardiovascular disease (CVD), 5 CRC nurses and 6 CR clinicians participated in the qualitative study. Referral of postsurgical CRC survivors to weekly CR exercise classes and information sessions. Classes included CRC survivors and people with CVD. CR nurses and physiotherapists were given training about cancer and exercise. Barriers to CR were protracted recoveries from surgery, ongoing treatments and poor mobility. No adverse events were reported during the trial, suggesting that CR is safe. 62% of participants completed the intervention as per protocol and had high levels of attendance. 20 health professionals attended the cancer and exercise training course, rating it as excellent. Participants perceived that CR increased CRC survivors’ confidence and motivation to exercise, and offered peer support. CR professionals were concerned about CR capacity to accommodate cancer survivors and their ability to provide psychosocial support to this group of patients. CR is feasible and acceptable for postsurgical CRC survivors. A large-scale effectiveness trial of the intervention should be conducted. ISRCTN63510637.