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慢性病自我管理项目对癌症幸存者的适应性:可行性、可接受性及实施经验

Adaptation of the chronic disease self-management program for cancer survivors: feasibility, acceptability, and lessons for implementation.

作者信息

Risendal B, Dwyer A, Seidel R, Lorig K, Katzenmeyer C, Coombs L, Kellar-Guenther Y, Warren L, Franco A, Ory M

机构信息

Community and Behavioral Health, Colorado School of Public Health, University of Colorado Cancer Center, 13001 E. 17th Street, MS F538, Aurora, CO, 80045, USA,

出版信息

J Cancer Educ. 2014 Dec;29(4):762-71. doi: 10.1007/s13187-014-0652-8.

Abstract

Self-management in chronic disease has been shown to improve patient-reported and health care-related outcomes. However, relatively little information about its utility in cancer survivorship is known. We evaluated the feasibility and acceptability of the delivery of an adaptation of the evidence-based Chronic Disease Self-management Program (Stanford) called Cancer Thriving and Surviving (CTS). Triangulated mixed methods were used to capture baseline characteristics and post-program experiences using a combination of closed- and open-ended survey items; emergent coding and simple descriptive statistics were used to summarize the data. Twenty-seven workshops were delivered by 22 CTS leaders to 244 participants between August 2011 and January 2013 in a variety of settings (48 % community, 30 % health care, 22 % regional/community cancer center). Representing a variety of cancer types, about half the participants were 1-3 years post-diagnosis and 45 % were 4 or more years from diagnosis. Program attendance was high with 84 % of participants attending four or more of the six sessions in the workshop. Overall, 95 % of the participants were satisfied with the program content and leaders, and would recommend the program to friends and family. These results confirm the feasibility and acceptability of delivery of a high-fidelity, peer-led model for self-management support for cancer survivors. Expansion of the CTS represents a powerful tool toward improving health-related outcomes in this at-risk population.

摘要

慢性病的自我管理已被证明能改善患者报告的结局以及与医疗保健相关的结局。然而,关于其在癌症幸存者中的效用的信息相对较少。我们评估了一种基于循证的慢性病自我管理项目(斯坦福模式)改编而来的名为“癌症蓬勃生存”(CTS)项目实施的可行性和可接受性。采用三角混合方法,通过封闭式和开放式调查项目相结合的方式来获取基线特征和项目后的体验;使用紧急编码和简单描述性统计来汇总数据。2011年8月至2013年1月期间,22名CTS负责人在各种场所举办了27次工作坊,共有244名参与者(48%来自社区,30%来自医疗保健机构,22%来自地区/社区癌症中心)。参与者代表了多种癌症类型,约一半的参与者在确诊后1至3年,45%的参与者距离确诊已4年或更长时间。项目的出勤率很高,84%的参与者参加了工作坊六次课程中的四次或更多次。总体而言,95%的参与者对项目内容和负责人感到满意,并会向朋友和家人推荐该项目。这些结果证实了为癌症幸存者提供高保真、同伴主导的自我管理支持模式的可行性和可接受性。CTS项目的扩展是改善这一高危人群健康相关结局的有力工具。

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