Centre for Behavioural Research in Cancer Council, The Cancer Council Victoria, Carlton, Victoria, Australia.
Psychooncology. 2012 Oct;21(10):1053-62. doi: 10.1002/pon.2019. Epub 2011 Jul 18.
The objective was to assess the effectiveness of a volunteer-delivered tailored telephone-based intervention in reducing prevalence of unmet supportive care needs, elevated levels of anxiety and depression among people with colorectal cancer over a 9-month period.
There were 653 participants who completed the baseline questionnaire and were randomised to usual care (n = 341) or intervention (n = 306). Three follow-up questionnaires were completed at 3-monthly intervals (response rates: 93%, 87%, 82%, respectively). All four questionnaires contained the Supportive Care Needs Survey (SCNS), Hospital Anxiety and Depression Scale (HADS) and checklists for colorectal cancer symptoms and use of support services. The intervention consisted of trained volunteers providing emotional support, service referral and information and was delivered after completion of each of the first three questionnaires. Primary outcomes were prevalence of moderate to high SCNS needs and elevated levels (scores of 8+) of HADS anxiety and depression.
Over the study period, SCNS needs decreased similarly for both groups, and prevalence of elevated depression did not change for either group. There was a greater reduction in the prevalence of elevated anxiety in the intervention than usual care group (p < 0.01), with the intervention group decrease mainly occurring between baseline and the first follow-up survey (p < 0.01). However, the prevalence of elevated anxiety was similar between the two groups at each follow-up point.
The intervention had no effect on supportive care needs or depression, although it may be associated with a greater reduction in anxiety. Future research should test the intervention with patients closer to diagnosis.
评估志愿者提供的定制电话干预在 9 个月内减少结直肠癌患者未满足的支持性护理需求、焦虑和抑郁水平升高的效果。
共有 653 名参与者完成了基线问卷,并被随机分配至常规护理组(n=341)或干预组(n=306)。在 3 个月的时间间隔内完成了 3 次随访问卷(应答率分别为 93%、87%、82%)。所有 4 份问卷均包含支持性护理需求调查(SCNS)、医院焦虑和抑郁量表(HADS)以及结直肠癌症状和支持服务使用清单。干预措施包括培训志愿者提供情感支持、服务转介和信息,并在完成前三份问卷中的每一份后进行。主要结局是中度至高度 SCNS 需求的发生率和 HADS 焦虑和抑郁的高分(得分 8+)。
在研究期间,两组的 SCNS 需求均相似下降,且两组的抑郁高分发生率均未改变。干预组的焦虑高分发生率的降低明显大于常规护理组(p<0.01),干预组的主要降低发生在基线和第一次随访调查之间(p<0.01)。然而,在每个随访点,两组的焦虑高分发生率相似。
该干预措施对支持性护理需求或抑郁没有影响,尽管它可能与焦虑的更大降低有关。未来的研究应在更接近诊断的患者中测试该干预措施。