Rawl Susan M, Given Barbara A, Given Charles W, Champion Victoria L, Kozachik Sharon L, Kozachik Sharon L, Barton Debra, Emsley Christine L, Williams Stephen D
School of Nursing, Indiana University, Indianapolis, IN, USA.
Oncol Nurs Forum. 2002 Jul;29(6):967-75. doi: 10.1188/02.ONF.967-975.
PURPOSE/OBJECTIVES: To test the effects of a computer-based nursing intervention designed to provide patients and family caregivers with concrete, objective information on symptom management; provide education about disease and treatment; coordinate medical resources; and provide emotional support and counseling.
Two-site, randomized clinical trial.
A large, urban, midwestern, tertiary-cancer center and a community-based cancer center in a medium-sized midwestern city.
109 patients newly diagnosed with breast, colon, or lung cancer who were receiving chemotherapy; 54 received standard care, and 55 participated in the intervention group.
Outcome data were collected via structured telephone interviews at three time points: baseline, midway through the intervention, and one month postintervention. The intervention consisting of nine visits, five in person and four by telephone, was conducted over 18 weeks by advanced practice oncology nurses.
Psychosocial functioning, anxiety, and depression.
Patients who received the intervention had significantly less depression between baseline and the midway point, as well as less anxiety and greater improvement in the role-emotional and mental health subscales of the Medical Outcomes Study 36 Short Form.
Cancer-care nursing interventions can decrease psychosocial morbidity and improve quality of life for newly diagnosed patients with cancer undergoing treatment. Additional research is needed to understand who benefited most from the intervention.
This nurse-directed intervention resulted in improved mental health for patients; however, physical subscales were not changed. Further work is needed to determine why depression and mental health were affected yet physical health and symptoms did not differ between groups. Results support the important role of nurses in addressing mental health issues in patients and families experiencing cancer.
目的/目标：测试一项基于计算机的护理干预措施的效果，该干预旨在为患者及家庭护理人员提供有关症状管理的具体客观信息；开展疾病与治疗相关教育；协调医疗资源；提供情感支持与咨询服务。
双中心随机临床试验。
一家位于中西部大城市的大型三级癌症中心以及中西部一个中等规模城市的社区癌症中心。
109名新诊断为乳腺癌、结肠癌或肺癌且正在接受化疗的患者；54名接受标准护理，55名参与干预组。
在三个时间点通过结构化电话访谈收集结果数据：基线期、干预进行至中途以及干预结束后一个月。由高级肿瘤专科护士在18周内进行干预，包括9次访视，其中5次面对面访视，4次电话访视。
心理社会功能、焦虑和抑郁。
接受干预的患者在基线期至中途期间抑郁程度显著降低，在医学结局研究简表36项的角色-情感和心理健康分量表上焦虑程度更低且改善更大。
癌症护理干预措施可降低新诊断的正在接受治疗的癌症患者的心理社会发病率并改善其生活质量。需要进一步研究以了解谁从该干预中获益最大。
这项由护士主导的干预措施改善了患者的心理健康；然而，身体状况分量表未发生变化。需要进一步研究以确定为何抑郁和心理健康受到影响而两组之间的身体健康和症状并无差异。结果支持了护士在解决癌症患者及其家庭心理健康问题方面的重要作用。
