Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: A pilot study.
Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: A pilot study.
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DOI：
10.3389/fgwh.2022.1058559
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发表时间：
2022
影响因子：
--
通讯作者：
Flores, Idhaliz
中科院分区：
文献类型：
--
作者：
Nieves-Vazquez, Cristina I.;Detres-Marquez, Amanda C.;Torres-Reveron, Annelyn;Appleyard, Caroline B.;Llorens-De Jesus, Astrid P.;Resto, Ivana N.;Lopez-Rodriguez, Veronica;Ramos-Echevarria, Paola M.;Castro, Eida M.;Flores, Idhaliz
关键词：
我们之前已经证明，环境丰富(EE)--包括社会支持、新鲜感和开放空间--减少了子宫内膜异位症大鼠模型的疾病进展和焦虑。我们开发了一种新的EE干预措施，将在先导性随机临床试验(RCT)中对子宫内膜异位症患者进行测试，子宫内膜异位症是一种痛苦、压力大的疾病。翻译和评估适应的EE干预作为子宫内膜异位症患者标准护理的辅助手段的可行性和可接受性。可行性通过招募、注册和遵从率进行评估。干预结束3个月后，通过干预后调查和焦点小组讨论评估可接受性。在招募的103名受试者中，被随机分为干预组和对照组。在干预开始时，研究组包括29名(干预组)和27名(对照组)受试者。干预组和对照组的入院率分别为45.3%和69.2%，依从率分别为41.4%和100%。自然事件(地震、新冠肺炎大流行)造成的延误影响了入学率和遵从率。错过干预的最常见原因是经期疼痛(39.1%)和工作学习(34.8%)。干预的后勤服务的可接受性很高(80%)。大多数受试者(82.4%)会继续定期参加支持小组，95.7%的受试者会建议对其他患者进行干预。我们表明，EE可以转化为一种可接受的综合多模式治疗，在完成干预的参与者中被认为是有价值的。高磨损率/低粘附率表明需要进行额外的改进以提高可行性。可接受性数据表明，EE有可能被整合到子宫内膜异位症和其他炎症性、痛性疾病患者的临床治疗中。评估EE在改善疼痛症状、心理健康和生活质量(QOL)方面的有效性的研究正在进行中。
We have previously shown that Environmental Enrichment (EE)-consisting of social support, novelty, and open spaces—decreased disease progression and anxiety in a rat model of endometriosis. We developed a novel EE intervention to be tested in a pilot randomized clinical trial (RCT) in patients with endometriosis, a painful, stressful disease. To translate and evaluate the feasibility and acceptability of an adapted EE intervention as an adjuvant to standard-of-care for endometriosis patients. Feasibility was assessed through recruitment, enrollment, and adherence rates. Acceptability was evaluated through a post-intervention survey and focus group discussion 3-months after the end of the intervention. Of the 103 subjects recruited, 64 were randomized to the intervention group and 39 to the control group. At the start of the intervention, the study groups consisted of 29 (intervention) and 27 (control) subjects. Enrollment rates were 45.3% and 69.2%, and adherence rates were 41.4% and 100% for the intervention and control groups, respectively. Delays resulting from natural events (earthquakes, the COVID-19 pandemic) impacted enrollment and adherence rates. The most common reasons for missing an intervention were period pain (39.1%) and work-study (34.8%). There was high acceptability (>80%) of the intervention's logistics. The majority (82.4%) of subjects would continue participating in support groups regularly, and 95.7% would recommend the intervention to other patients. We showed that EE could be translated into an acceptable integrative multi-modal therapy perceived as valuable among participants who completed the intervention. High attrition/low adherence indicates that additional refinements would be needed to improve feasibility. Acceptability data indicate that EE has the potential to be integrated into the clinical management of patients with endometriosis and other inflammatory, painful disorders. Studies are ongoing to assess the efficacy of EE in improving pain symptoms, mental health, and quality of life (QoL).
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