Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Psychooncology. 2012 Nov;21(11):1195-204. doi: 10.1002/pon.2013. Epub 2011 Jul 12.
The generalizability of palliative care intervention research is often limited by high rates of study attrition. This study examined factors associated with attrition from a randomized controlled trial comparing meaning-centered group psychotherapy (MCGP), an intervention designed to help advanced cancer patients sustain or enhance their sense of meaning to the supportive group psychotherapy (SGP), a standardized support group.
Patients with advanced solid tumor cancers (n = 153) were randomized to eight sessions of either the MCGP or SGP. They completed assessments of psychosocial, spiritual, and physical well-being pretreatment, midtreatment, and 2 months post-treatment. Attrition was assessed in terms of the percent of participants who failed to complete these assessments, and demographic, psychiatric, medical, and study-related correlates of attrition were examined for the participants in each of these categories.
The rates of attrition at these time points were 28.1%, 17.7%, and 11.1%, respectively; 43.1% of the participants (66 of 153) completed the entire study. The most common reason for dropout was patients feeling too ill. Attrition rates did not vary significantly between study arms. The participants who dropped out pretreatment reported less financial concerns than post-treatment dropouts, and the participants who dropped out of the study midtreatment had poorer physical health than treatment completers. There were no other significant associations between attrition and any demographic, medical, psychiatric, or study-related variables.
These findings highlight the challenge of maintaining advanced cancer patients in longitudinal research and suggest the need to consider alternative approaches (e.g., telemedicine) for patients who might benefit from group interventions but are too ill to travel.
姑息治疗干预研究的普遍性通常受到研究脱落率高的限制。本研究探讨了一项随机对照试验中脱落的相关因素，该试验比较了以意义为中心的团体心理疗法（MCGP）和支持性团体心理疗法（SGP），前者旨在帮助晚期癌症患者维持或增强其意义感，后者为标准化支持团体。
将 153 例晚期实体瘤癌症患者随机分配至 MCGP 或 SGP 组，共 8 次。他们在治疗前、治疗中期和治疗后 2 个月完成了心理社会、精神和身体幸福感的评估。根据未完成这些评估的参与者比例评估脱落情况，并检查每个组别的参与者中与人口统计学、精神病学、医学和研究相关的脱落因素。
这些时间点的脱落率分别为 28.1%、17.7%和 11.1%；43.1%的参与者（153 名中的 66 名）完成了整个研究。退出的最常见原因是患者感到太虚弱。两组之间的脱落率没有显著差异。治疗前退出的参与者报告的财务问题比治疗后退出的参与者少，治疗中期退出研究的参与者的身体健康状况比治疗完成者差。在脱落与任何人口统计学、医学、精神病学或研究相关变量之间没有其他显著关联。
这些发现强调了在纵向研究中维持晚期癌症患者的挑战，并表明需要考虑替代方法（例如远程医疗），为可能受益于团体干预但因身体虚弱而无法旅行的患者提供帮助。
