Mindfulness Training Supports Quality of Life and Advance Care Planning in Adults With Metastatic Cancer and Their Caregivers: Results of a Pilot Study.
Mindfulness Training Supports Quality of Life and Advance Care Planning in Adults With Metastatic Cancer and Their Caregivers: Results of a Pilot Study.
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DOI：
10.1177/1049909119862254
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发表时间：
2020-02
期刊：
影响因子：
--
通讯作者：
Helft PR
中科院分区：
文献类型：
--
作者：
Johns SA;Beck-Coon K;Stutz PV;Talib TL;Chinh K;Cottingham AH;Schmidt K;Shields C;Stout ME;Stump TE;Monahan PO;Torke AM;Helft PR
情绪困扰通常会导致癌症患者及其家庭照顾者（FCG）避免临终讨论和提前护理计划（ACP），这可能会破坏生活质量（QoL）。大多数非加太干预措施未能解决阻碍及时非加太的情感障碍。我们评估了以正念为基础的干预措施的可行性，可接受性和初步效果，以促进晚期癌症成人及其FCG的ACP。进行了一项单臂试验，以评估为期6周的团体正念干预对ACP行为（仅限患者），QoL，家庭沟通，回避应对，痛苦和其他结果从基线（T1）到干预后（T2）和1个月后（T3）的影响。符合条件的患者患有晚期实体恶性肿瘤，ACP参与有限，并且FCG愿意参与。13对二人组（N=26名参与者）在美国的一个学术癌症中心入组。在合格患者中，59.1%入组。到T3的出勤率（6次治疗中为70.8%）和保留率（患者为84.6%; FCG为92.3%）可接受。超过90%的完成者报告了高干预满意度。从T1到T3，患者参与度在评估的三种ACP行为中均增加了一倍以上。患者在T2和T3时报告了痛苦的显著减少。在T2和T3时，FCG报告了生活质量和家庭沟通的显著改善。T3时，患者和FCG均报告睡眠障碍和回避应对显著减少。正念干预是可行的和可接受的，并支持改善ACP和患者和FCG的相关结果。一项针对ACP的正念训练的随机试验是必要的。本研究在ClinicalTrials.gov注册，标识符为NCT 02367508（https：clinicaltrials.gov/ct2/show/ NCT 02367508）。
Emotional distress often causes cancer patients and their family caregivers (FCGs) to avoid end-of-life discussions and advance care planning (ACP), which may undermine quality of life (QoL). Most ACP interventions fail to address emotional barriers that impede timely ACP. We assessed feasibility, acceptability, and preliminary effects of a mindfulness-based intervention to facilitate ACP for adults with advanced-stage cancer and their FCGs. A single-arm pilot was conducted to assess impact of a 6-week group mindfulness intervention on ACP behaviors (patients only), QoL, family communication, avoidant coping, distress, and other outcomes from baseline (T1) to post-intervention (T2) and 1 month later (T3). Eligible patients had advanced-stage solid malignancies, limited ACP engagement, and a FCG willing to participate. Thirteen dyads (N=26 participants) enrolled at an academic cancer center in the United States. Of eligible patients, 59.1% enrolled. Attendance (70.8% across 6 sessions) and retention (84.6% for patients; 92.3% for FCGs) through T3 were acceptable. Over 90% of completers reported high intervention satisfaction. From T1 to T3, patient engagement more than doubled in each of three ACP behaviors assessed. Patients reported large significant decreases in distress at T2 and T3. FCGs reported large significant improvements in QoL and family communication at T2 and T3. Both patients and FCGs reported notable reductions in sleep disturbance and avoidant coping at T3. The mindfulness intervention was feasible and acceptable and supported improvements in ACP and associated outcomes for patients and FCGs. A randomized trial of mindfulness training for ACP is warranted. The study is registered at ClinicalTrials.gov with identifier NCT02367508 (https://clinicaltrials.gov/ct2/show/ NCT02367508).
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DOI：
10.1007/s00520-016-3220-4
发表时间：
2016-10
期刊：
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
影响因子：
--
作者：
Johns SA;Brown LF;Beck-Coon K;Talib TL;Monahan PO;Giesler RB;Tong Y;Wilhelm L;Carpenter JS;Von Ah D;Wagner CD;de Groot M;Schmidt K;Monceski D;Danh M;Alyea JM;Miller KD;Kroenke K
通讯作者：
Kroenke K
影响因子：
3.5
作者：
Hann, DM;Denniston, MM;Baker, F
通讯作者：
Baker, F
影响因子：
4.2
作者：
Jha, Amishi P.;Stanley, Elizabeth A.;Gelfand, Lois
通讯作者：
Gelfand, Lois
影响因子：
3.8
作者：
Henderson, Virginia P.;Clemow, Lynn;Massion, Ann O.;Hurley, Thomas G.;Druker, Susan;Hebert, James R.
通讯作者：
Hebert, James R.
影响因子：
45.3
作者：
Fu, Siqing;Barber, F. Diane;Kurzrock, Razelle
通讯作者：
Kurzrock, Razelle