Effectiveness of an interdisciplinary palliative care intervention for family caregivers in lung cancer.
Effectiveness of an interdisciplinary palliative care intervention for family caregivers in lung cancer.
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DOI：
10.1002/cncr.29567
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发表时间：
2015-10-15
期刊：
影响因子：
6.2
通讯作者：
Ferrell B
中科院分区：
文献类型：
--
作者：
Sun V;Grant M;Koczywas M;Freeman B;Zachariah F;Fujinami R;Del Ferraro C;Uman G;Ferrell B
家庭照顾者(FCGS)在照顾肺癌患者时，生活质量显著下降。这项研究测试了跨学科姑息治疗干预对诊断为I-IV期非小细胞肺癌(NSCLC)患者的FCGS的有效性。被患者确定为主要照顾者的FCGS被登记在一项前瞻性的准实验研究中，在这项研究中，首先是常规护理组，然后是干预组。干预组中的FCG被介绍在跨学科护理会议上，他们还接受了在身体、心理、社会和精神领域组织的四次教育会议。这些会议包括支持FCG自身需求的自我护理计划。在基线和12周时，使用有效的测量方法评估照顾者负担、照看技能准备、心理苦恼和FCG生活质量。共有366个FCGS被纳入初步分析。与常规护理组相比，接受跨学科姑息护理干预的FCGS在12周时在社会幸福感方面的得分(5.84比6.86；p<；.001)和较低的心理痛苦(4.61比4.20；p=.010)显著更高。与常规护理组的FCGS相比，干预组的FCGS的照顾者负担显著减少(p=.008)。肺癌姑息治疗的跨学科方法在统计上显著改善了FCG的社会幸福感、心理痛苦，并减轻了照顾者的负担。
Family caregivers (FCGs) experience significant deteriorations in quality of life while caring for lung cancer patients. This study tested the effectiveness of an interdisciplinary palliative care intervention for FCGs of patients diagnosed with stage I–IV non-small cell lung cancer (NSCLC). FCGs who were identified by patients as the primary caregiver were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. FCGs in the intervention group were presented at interdisciplinary care meetings, and they also received four educational sessions organized in the physical, psychological, social, and spiritual domains. The sessions included self-care plans to support the FCG’s own needs. Caregiver burden, caregiving skills preparedness, psychological distress, and FCG QOL were assessed at baseline and 12 weeks using validated measures. A total of 366 FCGs were included in the primary analysis. FCGs who received the interdisciplinary palliative care intervention had significantly better scores for social well-being (5.84 vs. 6.86; p<.001) and lower psychological distress (4.61 vs. 4.20; p=.010) at 12 weeks compared to FCGs in the usual care group. FCGs in the intervention group had significantly less caregiver burden compared to FCGs in the usual care group (p=.008). An interdisciplinary approach to palliative care in lung cancer resulted in statistically significant improvements in the FCG’s social well-being, psychological distress, and less caregiver burden.