The ENHANCES study: a randomised controlled trial of a nurse-led survivorship intervention for patients treated for head and neck cancer
The ENHANCES study: a randomised controlled trial of a nurse-led survivorship intervention for patients treated for head and neck cancer
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DOI：
10.1007/s00520-019-04748-7
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发表时间：
2019-12-01
影响因子：
3.1
通讯作者：
Mackenzie, Lisa
中科院分区：
文献类型：
--
作者：
Turner, Jane;Yates, Patsy;Mackenzie, Lisa
目的：本研究旨在评估由护士实施的头颈癌幸存者自我管理护理计划（HNCP）对已完成头颈癌（HNC）治疗的患者的有效性。方法对10名肿瘤科护士进行HNCP的培训。HNCP包括一个面对面的长达一小时的会议，其中记录了患者的治疗，以及参与其护理和随访计划的卫生专业人员的联系方式。指导患者为他们未来的幸福提出多达三个目标，并协助制定实现这些目标的行动计划。HNCP已交给患者，并将副本转发给他们的初级保健医生。109例患者在明确的治愈性治疗后被随机分配，36例接受HNCP治疗，36例接受生存信息治疗，37例接受常规治疗。通过意向治疗分析的主要结局是FACT-H&N测量的从基线到6个月随访的生活质量变化。结果3个月时各组患者的生活质量均有所下降，但6个月时已接近基线水平。与常规护理组相比，6个月时信息组在身体健康领域的唯一统计学显著平均差异（平均差异0.4，95% - 1.8，2.6，p < 0.05）。结论：与常规护理相比，单次护理干预不足以改善HNC幸存者的生活质量。提供关于HNC存活率的详细书面信息与改善身体健康相关。
Purpose A randomised controlled trial was conducted to evaluate the effectiveness of a nurse-delivered Head and Neck Cancer Survivor Self-Management Care Plan (HNCP) for patients who had completed treatment for head and neck cancer (HNC). Methods Ten oncology nurses were trained to deliver the HNCP. The HNCP consisted of one face-to-face hour-long meeting in which the patient's treatment was recorded, as were contact details of health professionals involved in their care and follow-up schedules. Patients were guided to nominate up to three goals for their future well-being and assisted to devise an action plan to achieve these. The HNCP was given to the patient and a copy was forwarded to their primary care physician. One hundred and nine patients were randomised after definitive curative intent treatment, 36 to HNCP, 36 to receive information about survivorship, and 37 to usual care. The primary outcome, analysed by intention-to-treat, was change in quality of life measured by the FACT-H&N from baseline to 6-month follow-up. Results Quality of life of all groups decreased at 3 months but was close to baseline at 6 months. Compared with the usual care group, the only statistically significant mean difference at 6 months was for the information group on the physical well-being domain (mean difference 0.4, 95% - 1.8, 2.6, p < 0.05). Conclusions A single-session nurse-delivered intervention is insufficient to improve the quality of life in HNC survivors compared with usual care. Provision of detailed written information about HNC survivorship is associated with improved physical well-being.