An Early Palliative Care Telehealth Coaching Intervention to Enhance Advanced Cancer Family Caregivers' Decision Support Skills: The CASCADE Pilot Factorial Trial.
An Early Palliative Care Telehealth Coaching Intervention to Enhance Advanced Cancer Family Caregivers' Decision Support Skills: The CASCADE Pilot Factorial Trial.
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DOI：
10.1016/j.jpainsymman.2021.07.023
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发表时间：
2022-01
影响因子：
4.7
通讯作者：
Bakitas MA
中科院分区：
文献类型：
--
作者：
Dionne-Odom JN;Wells RD;Guastaferro K;Azuero A;Hendricks BA;Currie ER;Bechthold A;Dosse C;Taylor R;Reed RD;Harrell ER;Gazaway S;Engler S;McKie P;Williams GR;Sudore R;Rini C;Rosenberg AR;Bakitas MA
晚期癌症患者往往涉及家庭照顾者在健康相关的决策，从诊断到生命结束，但是，很少有干预措施已经开发，以提高照顾者的决策支持技能。评估可行性，可接受性，和CASCADE（CARE支持者被训练成为熟练的决策伙伴），早期远程保健，姑息治疗教练主导的决策支持培训干预护理人员的个人干预组件的潜在疗效。使用多阶段优化策略的试点析因试验（2019年10月至2020年10月）。新诊断晚期癌症的家庭照顾者和他们的照顾者（n = 46对）被随机分配到8个实验条件之一，包括以下三个CASCADE组成部分之一的组合：1）有效的决策支持心理教育; 2）决策支持沟通培训;和3）渥太华决策指南培训。通过完成会话和问卷调查（预定义为≥80%）评估可行性。通过干预后访谈和参与者对其推荐可能性的评级来确定可接受性。在12周和24周时收集有效决策支持、护理人员和患者痛苦的测量结果。护理人员参与者完成了78%的干预会议和81%的问卷调查;患者完成了80%的问卷调查。在不同的条件下，护理人员向其他人推荐该计划的平均评分为9.9，从1-完全不可能到10-非常可能。个别级联组件被观察到有效的决策支持和照顾者的痛苦有潜在的好处。我们成功地进行了析因试验设计，以检查一种新的干预措施的组成部分，以提高晚期癌症家庭照顾者的决策支持技能。一个充分的动力因子试验是必要的。
Patients with advanced cancer often involve family caregivers in health-related decision-making from diagnosis to end-of-life; however, few interventions have been developed to enhance caregiver decision support skills. Assess the feasibility, acceptability, and potential efficacy of individual intervention components of CASCADE (CAre Supporters Coached to be Adept DEcision Partners), an early telehealth, palliative care coach-led decision support training intervention for caregivers. Pilot factorial trial using the multiphase optimization strategy (October 2019-October 2020). Family caregivers and their care recipients with newly-diagnosed advanced cancer (n = 46 dyads) were randomized to1 of 8 experimental conditions that included a combination of one of the following three CASCADE components: 1) effective decision support psychoeducation; 2) decision support communication training; and 3) Ottawa Decision Guide training. Feasibility was assessed by completion of sessions and questionnaires (predefined as ≥80%). Acceptability was determined through postintervention interviews and participants’ ratings of their likelihood to recommend. Measures of effective decision support and caregiver and patient distress were collected at Twelve and Twenty four weeks. Caregiver participants completed 78% of intervention sessions and 81% of questionnaires; patients completed 80% of questionnaires. Across conditions, average caregiver ratings for recommending the program to others was 9.9 on a scale from 1-Not at all likely to 10-Extremely likely. Individual CASCADE components were observed to have potential benefit for effective decision support and caregiver distress. We successfully piloted a factorial trial design to examine components of a novel intervention to enhance the decision support skills of advanced cancer family caregivers. A fully-powered factorial trial is warranted.
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影响因子：
4.7
作者：
Dionne-Odom, J. Nicholas;Azuero, Andres;Bakitas, Marie A.
通讯作者：
Bakitas, Marie A.
影响因子：
2.8
作者：
Bakitas, Marie;Kryworuchko, Jennifer;Volandes, Angelo E.
通讯作者：
Volandes, Angelo E.
影响因子：
2.1
作者：
Ingoldsby, Erin M.
通讯作者：
Ingoldsby, Erin M.
影响因子：
5.4
作者：
Clayman, ML;Roter, D;Bandeen-Roche, K
通讯作者：
Bandeen-Roche, K
影响因子：
4.7
作者：
Butow, Phyllis N.;Price, Melanie A.;Friedlander, Michael
通讯作者：
Friedlander, Michael