Mishel Merle H, Germino Barbara B, Belyea Michael, Stewart Janet L, Bailey Donald E, Mohler James, Robertson Cary
School of Nursing, University of North Carolina at Chapel Hill, 27599, USA.
Nurs Res. 2003 Mar-Apr;52(2):89-97. doi: 10.1097/00006199-200303000-00005.
The effectiveness of psycho-educational interventions for cancer patients is well documented, but less is known about moderating characteristics that determine which subgroups of patients are most likely to benefit.
The aim of this study was to determine whether certain individual characteristics of African-American and White men with localized prostate cancer moderated the effects of a psycho-educational Uncertainty Management Intervention on the outcomes of cancer knowledge and patient-provider communication
Men were blocked by ethnicity and randomly assigned to one of three conditions: Uncertainty Management Intervention provided to the patient only, Uncertainty Management Intervention supplemented by delivery to the patient and family member, or usual care. The individual characteristics explored were education, sources for information, and intrinsic and extrinsic religiosity.
Using repeated measures multivariate analysis of variance, findings indicated that there were no significant moderator effects for intrinsic religiosity on any of the outcomes. Lower level of education was a significant moderator for improvement in cancer knowledge. For the outcome of patient-provider communication, fewer sources for cancer information was a significant moderator for the amount told the patient by the nurse and other staff. Less extrinsic religiosity was a significant moderator for three areas of patient provider communication. The three areas are the amount (a) the physician tells the patient; (b) the patient helps with planning treatment; and (c) the patient tells the physician.
Testing for moderator effects provides important information regarding beneficiaries of interventions. In the current study, men's levels of education, amount of sources for information, and extrinsic religiosity influenced the efficacy of the Uncertainty Management Intervention on important outcomes.
心理教育干预对癌症患者的有效性已有充分记录，但对于决定哪些患者亚组最可能受益的调节特征却知之甚少。
本研究旨在确定患有局限性前列腺癌的非裔美国男性和白人男性的某些个体特征是否会调节心理教育不确定性管理干预对癌症知识结果和医患沟通的影响。
男性按种族分组，随机分配到三种情况之一：仅向患者提供不确定性管理干预、向患者和家庭成员提供补充的不确定性管理干预或常规护理。所探讨的个体特征包括教育程度、信息来源以及内在和外在宗教信仰。
使用重复测量方差多元分析，结果表明内在宗教信仰对任何结果均无显著调节作用。较低的教育水平是癌症知识改善的显著调节因素。对于医患沟通的结果，较少的癌症信息来源是护士和其他工作人员告知患者信息数量的显著调节因素。较少的外在宗教信仰是医患沟通三个方面的显著调节因素。这三个方面是：（a）医生告知患者的信息量；（b）患者协助治疗计划制定的程度；（c）患者告知医生的信息量。
调节效应测试为干预的受益者提供了重要信息。在当前研究中，男性的教育水平、信息来源数量和外在宗教信仰影响了不确定性管理干预对重要结果的疗效。
