Division of Medical Oncology, Department of Medicine, Duke University Medical Center (DUMC), Durham, NC 27710, USA.
Support Care Cancer. 2010 Jul;18(7):893-8. doi: 10.1007/s00520-010-0823-z. Epub 2010 Feb 9.
Pathfinders is a multi-faceted psychosocial care program for cancer patients; it was developed in community oncology and adapted to the academic oncology setting. This prospective, single-arm, phase 2 pilot study examined the acceptability and feasibility of Pathfinders for women with metastatic breast cancer.
Over 3 months, participants completed patient-reported surveys including the Patient Care Monitor (PCM, review of systems), Functional Assessment of Chronic Illness Therapy-Breast Cancer (FACT-B), Self Efficacy, and a single-item survey asking patients whether the program was helpful to them. A technology-based data collection system was used to capture electronic patient-reported outcomes at point of care, report symptoms in real time to clinicians, and collect warehouse data to provide a detailed longitudinal picture of the patient experience when receiving Pathfinders.
Participants (n = 50) were: mean age 51 (SD 11); 76% white, 20% black; 74% married; 50% college degree. Forty-two (n = 42) patients completed baseline and 3-month assessments. Statistically significant improvements (all P < 0.05) occurred in PCM subscales for Distress (mean [SE] = -3.42 [1.21]), Despair (-4.53 [1.56]), and Quality of Life (2.88 [0.97]), and the FACT-B Emotional Wellbeing subscale (2.07 [0.46]). Of the 29 participants asked if Pathfinders was helpful, 27 (93%) responded positively and two did not respond. Other instruments measuring symptoms, quality of life, and self-efficacy showed improvement.
In a phase 2 pilot study, Pathfinders was helpful to patients and is feasible in an academic medical center. Follow-up data collected at the 3-month assessment suggest that the program impacts various psychological outcomes, notably distress and despair.
Pathfinders 是一个多方面的癌症患者心理社会关怀项目；它是在社区肿瘤学中开发的，并适用于学术肿瘤学环境。这项前瞻性、单臂、2 期试点研究考察了 Pathfinders 对转移性乳腺癌女性的可接受性和可行性。
在 3 个月的时间里，参与者完成了患者报告的调查，包括患者护理监测器（PCM，系统回顾）、慢性疾病治疗-乳腺癌功能评估量表（FACT-B）、自我效能感，以及一项要求患者回答该项目是否对他们有帮助的单项调查。一个基于技术的数据收集系统用于在护理点捕获电子患者报告的结果，实时向临床医生报告症状，并收集仓库数据，提供患者接受 Pathfinders 时的详细纵向体验。
参与者（n=50）：平均年龄 51（SD 11）；76%为白人，20%为黑人；74%已婚；50%具有大学学历。42 名（n=42）患者完成了基线和 3 个月的评估。PCM 子量表中的痛苦（均值[SE]=-3.42[1.21]）、绝望（-4.53[1.56]）和生活质量（2.88[0.97]）以及 FACT-B 情绪健康子量表（2.07[0.46]）均出现了统计学显著改善（均 P<0.05）。在被问及 Pathfinders 是否有帮助的 29 名参与者中，有 27 名（93%）回答是，有 2 名未回答。其他衡量症状、生活质量和自我效能感的工具也显示出改善。
在 2 期试点研究中，Pathfinders 对患者有帮助，并且在学术医疗中心是可行的。在 3 个月评估时收集的随访数据表明，该项目对各种心理结果产生了影响，特别是痛苦和绝望。
