Collinge and Associates, Eugene, OR 79405, USA.
Support Care Cancer. 2013 May;21(5):1405-14. doi: 10.1007/s00520-012-1682-6. Epub 2012 Dec 21.
A randomized controlled trial was conducted to evaluate outcomes of a multimedia instructional program for family caregivers in simple touch-based techniques to provide comfort to cancer patients at home.
A multilingual 78-min DVD and 66-page manual were produced for homebased instruction. Content addresses attitudes and communication about touch in cancer, psychological preparation for giving and receiving touch, safety precautions, massage techniques for comfort and relaxation, acupressure for specific cancer-related symptoms, and practice in the home setting. Materials were produced in English, Spanish, and Chinese versions. A community-based multiethnic sample of 97 adult patient/caregiver dyads was randomized to experimental (massage) or attention control (reading) groups for 4 weeks. Massage dyads received the program and instructions to practice at least three times per week, while control caregivers read to their patients for the same frequency. Self-report instruments assessed change in symptom severity, quality of life, perceived stress, and caregiver attitudes.
Significant reductions in all symptoms occurred for patients after both activities: 12-28 % reductions after reading vs. 29-44 % after massage. Massage caregivers showed significant gains in confidence, comfort, and self-efficacy using touch and massage as forms of caregiving.
Multimedia instruction in touch and massage methods may offer family members a viable means of enhancing self-efficacy and satisfaction in caregiving while decreasing patient pain, depression, and other symptoms. Family members may be able to learn and apply safe and simple methods that increase patient comfort and reduce distress.
本研究采用随机对照试验,评估了一种多媒体教学方案对居家癌症患者家属的效果,该方案旨在通过简单的触摸技术为患者提供舒适感,教学内容包括癌症患者触摸相关的态度和沟通、给予和接受触摸的心理准备、安全注意事项、用于舒适和放松的按摩技术、针对特定癌症相关症状的穴位按压,以及在家中进行实践。本教学方案有英、西、中三种语言版本,配套有 78 分钟的 DVD 和 66 页的使用手册。
本研究采用社区为基础的多民族样本,共纳入 97 对成年患者/照护者,将他们随机分配至实验组(按摩)或对照组(阅读),进行为期 4 周的干预。实验组患者家属接受方案并接受每周至少三次的实践指导,而对照组仅需为患者阅读手册。采用自我报告工具评估症状严重程度、生活质量、感知压力和照护者态度的变化。
两种干预措施(阅读或按摩)后患者的所有症状均显著减轻:阅读后症状减轻 12-28%,而按摩后减轻 29-44%。使用触摸和按摩作为护理形式,接受按摩指导的照护者在信心、舒适度和自我效能方面均有显著提升。
触摸和按摩方法的多媒体教学可能为家庭成员提供一种可行的方法,增强他们在护理过程中的自我效能感和满意度,同时减轻患者的疼痛、抑郁和其他症状。家庭成员可能能够学习和应用安全、简单的方法,增加患者的舒适度并减轻痛苦。