National Institutes of Health, Bethesda, Maryland, USA.
Cancer Nurs. 2010 Mar-Apr;33(2):E24-32. doi: 10.1097/NCC.0b013e3181be5e6d.
Allogeneic hematopoietic stem cell transplantation (HSCT) generates multiple problems that vary in complexity and create significant distress for both patients and their caregivers. Interventions that address patient and family caregiver distress during allogeneic hematopoietic stem cell transplantation (HSCT) have not been tested.
To evaluate the feasibility of conducting an individualized dyadic problem-solving education (PSE) intervention during HSCT and estimate a preliminary effect size on problem-solving skills and distress.
The PSE intervention consisted of 4 sessions of the Prepared Family Caregiver PSE model. Data were collected with an interventionist log, subject interviews and standardized questionnaires.
Of the 34 adult dyads screened, 24 were ineligible primarily because of being non-English-speaking (n = 11) and inconsistent caregivers (n = 10). Ten dyads (n = 20) were enrolled, and 8 dyads (n = 16) completed the intervention. Of the 31 sessions, 29 were completed (94%). Worsening patient condition was the primary reason for sessions to be incomplete. Patients attended 90% of the sessions; caregivers attended 74%. Reasons for missed sessions included patient symptom distress and limited caregiver availability. Dyads reported being very satisfied (mean, 4.8 [SD, 1.8]; range, 1-5), stating "an opportunity to talk" and "creative thinking" were most beneficial.
Results suggest that dyads can participate in PSE during HSCT and view it as beneficial. Participants identified the active process of solving problems as helpful.
Targeted interventions that promote effective, meaningful behaviors are needed to guide patients and caregivers through HSCT. Future research recommendations include testing a version of PSE with fewer sessions, including spousal and nonspousal caregivers and those who are non-English speaking.
异基因造血干细胞移植（HSCT）会产生多种问题，这些问题的复杂性各不相同，给患者及其护理人员带来了巨大的困扰。目前尚未对干预异基因造血干细胞移植（HSCT）期间患者和家庭护理人员的痛苦的措施进行测试。
评估在 HSCT 期间实施个体化的双重视角问题解决教育（PSE）干预的可行性，并初步评估其对问题解决技能和痛苦的影响。
PSE 干预包括 4 次预备家庭护理人员 PSE 模型。通过干预员日志、访谈和标准化问卷收集数据。
在筛选的 34 对成年患者及其护理人员中，有 24 对（82%）因主要是非英语语言（n=11）和护理人员不一致（n=10）而不合格。最终纳入 10 对（n=20）患者及其护理人员，其中 8 对（n=16）完成了干预。在 31 次访谈中，有 29 次（94%）完成。未完成的主要原因是患者病情恶化。患者参加了 90%的访谈，护理人员参加了 74%的访谈。未参加访谈的原因包括患者症状加重和护理人员可用性有限。患者及其护理人员对该干预非常满意（平均 4.8 [SD，1.8]；范围 1-5），表示“有机会交谈”和“创造性思维”最有益。
结果表明，HSCT 期间患者及其护理人员可以参与 PSE，并认为该干预有益。参与者认为积极解决问题的过程很有帮助。
需要有针对性的干预措施来促进有效的、有意义的行为，以指导患者及其护理人员完成 HSCT。未来的研究建议包括测试一种包含较少访谈次数的 PSE 版本，纳入配偶和非配偶护理人员，以及非英语语言者。
