Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy
Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy
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DOI：
10.1200/jco.2002.08.301
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发表时间：
2002-06-15
影响因子：
45.3
通讯作者：
Ruckdeschel, JC
中科院分区：
文献类型：
--
作者：
Jacobsen, PB;Meade, CD;Ruckdeschel, JC
目的：经专业管理的心理社会干预已被证明可改善化疗癌症患者的生活质量。本研究旨在通过评估患者自我管理的压力管理培训的效果和成本，改善化疗期间心理社会干预的可及性，这种培训需要有限的专业时间或经验来提供。患者和方法：411名即将开始化疗的患者被随机分配接受常规的心理社会护理，专业管理形式的压力管理培训，或患者自我管理形式的压力管理培训。在随机化之前和第二、第三和第四个治疗周期之前进行生活质量评估。从支付方和社会两方面估计干预费用。结果：与仅接受常规护理的患者相比，接受自我管理干预的患者报告显著(小于或等于。更好的身体机能，更强的活力，更少因情绪问题而受到角色限制，更健康的心理。相比之下，接受专业管理干预的患者在生活质量方面并不比仅接受常规护理的患者表现更好。据估计，自我干预的费用（从付款人的角度）比开始化疗的患者专业管理的心理社会干预的平均费用低66%至68%（从社会角度）。结论：关于自我管理压力管理培训的有效性和有利成本的证据表明，这种干预有可能大大提高患者在化疗期间获得心理社会干预的机会。(C) 2002年由美国临床肿瘤学会出版。
Purpose : Professionally administered psychosocial interventions have been shown to improve the quality of life of cancer patients undergoing chemotherapy. The present study sought to improve access to psychosocial interventions during chemotherapy treatment by evaluating the efficacy and costs of a patient self-administered form of stress management training that requires limited professional time or experience to deliver.Patients and Methods: Four hundred eleven patients about to start chemotherapy were randomly assigned to receive usual psychosocial care only, a professionally administered form of stress management training, or a patient self-administered form of stress management training. Quality-of-life assessments were conducted before randomization and before the second, third, and fourth treatment cycles. Intervention costs were estimated from both payer and societal perspectives.Results: Compared with patients who received usual care only, patients receiving the self-administered intervention reported significantly (Pless than or equal to.05) better physical functioning, greater vitality, fewer role limitations because of emotional problems, and better mental health. In contrast, patients who received the professionally administered intervention fared no better in terms of quality of life than patients receiving usual care only. Costs of the self-administered intervention were estimated to be 66% (from a payer perspective) to 68% (from a societal perspective) less than the average costs of professionally administered psychosocial interventions for patients starting chemotherapy.Conclusion: Evidence regarding the efficacy and favorable costs of self-administered stress management training suggests that this intervention has the potential to greatly improve patient access to psychosocial intervention during chemotherapy treatment. (C) 2002 by American Society of Clinical Oncology.