Department of Chaplain Services, Mayo Clinic, Rochester, MN, USA; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Psychooncology. 2014 Feb;23(2):216-21. doi: 10.1002/pon.3390. Epub 2013 Sep 9.
The aim of this randomized controlled trial for patients with advanced cancer receiving radiation therapy was to determine the effect of a multidisciplinary intervention on spiritual quality of life (QOL) at the end of the intervention (week 4) and at two follow-up time points (weeks 26 and 52).
One hundred thirty-one persons were randomized to either the intervention or control (forms only) groups. The intervention included six 90-min in-person sessions based on the physical, emotion, social, and spiritual domains of QOL. Three sessions included the spiritual component. Caregivers were present for four sessions, one which included a spiritual component. Ten follow-up phone calls were made to the patients in the intervention group during the 6-month follow-up period. Patients completed the Functional Assessment of Cancer Therapy: General Scale, the Linear Analog Self-Assessment which includes an assessment of spiritual QOL, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) at enrollment, and weeks 4, 27, and 52.
Following the intervention, the intervention group demonstrated improved spiritual QOL on the FACIT-Sp, whereas the spiritual QOL of the control group decreased, resulting in significant mean changes between groups (total score: 1.7 vs. -2.9; p < 0.01; meaning/peace subscale: 1.0 vs. -3.5; p < 0.01; faith subscale: 3.1 vs. -1.7; p = 0.04).
The results indicate that a multidisciplinary intervention which includes a spiritual component can maintain the spiritual QOL of patients with advanced cancer during radiation therapy.
本项针对接受放射治疗的晚期癌症患者的随机对照试验旨在确定多学科干预对干预结束时(第 4 周)和两个随访时间点(第 26 周和第 52 周)的精神生活质量(QOL)的影响。
将 131 名患者随机分为干预组或对照组(仅表格)。干预措施包括 6 次 90 分钟的面对面访谈,内容涉及 QOL 的身体、情感、社会和精神领域。其中 3 次访谈包括精神部分。4 次访谈有照顾者参加,其中一次包括精神部分。在 6 个月的随访期间,对干预组的患者进行了 10 次随访电话。患者在入组时以及第 4、27 和 52 周时完成了癌症治疗功能评估:一般量表、线性模拟自我评估,其中包括对精神 QOL 的评估,以及慢性疾病治疗功能评估:精神幸福感量表(FACIT-Sp)。
干预后,干预组的 FACIT-Sp 精神 QOL 得到改善,而对照组的精神 QOL 下降,导致组间平均变化显著(总分:1.7 与-2.9;p<0.01;意义/平静子量表:1.0 与-3.5;p<0.01;信仰子量表:3.1 与-1.7;p=0.04)。
结果表明,包含精神部分的多学科干预可以维持接受放射治疗的晚期癌症患者的精神 QOL。