Northouse Laurel, Schafenacker Ann, Barr Kathryn L C, Katapodi Maria, Yoon Hyojin, Brittain Kelly, Song Lixin, Ronis David L, An Larry
Author Affiliations: School of Nursing (Drs Northouse, Katapodi, and Ronis and Ms Yoon), Center for Health Communication Research (Dr An and Ms Barr), and Hospitals and Health Center (Ms Schafenacker), University of Michigan, Ann Arbor; College of Nursing (Dr Brittain), Michigan State University, Lansing; and School of Nursing (Dr Song), University of North Carolina-Chapel Hill.
Cancer Nurs. 2014 Sep-Oct;37(5):321-30. doi: 10.1097/NCC.0000000000000159.
Most programs addressing psychosocial concerns of cancer survivors are in-person programs that are expensive to deliver, have limited availability, and seldom deal with caregivers' concerns.
This study examined the feasibility of translating an efficacious nurse-delivered program (FOCUS Program) for patients and their caregivers to a tailored, dyadic Web-based format. Specific aims were to (1) test the preliminary effects of the Web-based intervention on patient and caregiver outcomes, (2) examine participants' program satisfaction, and (3) determine the feasibility of using a Web-based delivery format.
A phase 2 feasibility study was conducted with cancer patients (lung, breast, colorectal, prostate) and their family caregivers (N = 38 dyads). The Web-based intervention provided information and support tailored to the unique characteristics of each patient, caregiver, and their dyadic relationship. Primary outcomes were emotional distress and quality of life. Secondary outcomes were benefits of illness/caregiving, communication, support, and self-efficacy. Analyses included descriptive statistics and repeated-measures analysis of variance.
Dyads had a significant decrease in emotional distress, increase in quality of life, and perceived more benefits of illness/caregiving. Caregivers also had significant improvement in self-efficacy. There were no changes in communication. Participants were satisfied with program usability, but recommended additional content.
It was possible to translate a clinician-delivered program to a Web-based format that was easy to use and had positive effects on dyadic outcomes.
The Web-based program is a promising way to provide psychosocial care to more patients and caregivers using fewer personnel. It needs further testing in a larger randomized clinical trial.
大多数针对癌症幸存者心理社会问题的项目都是面对面的项目，实施成本高昂，可及性有限，且很少涉及照顾者的问题。
本研究探讨了将一项由护士实施的针对患者及其照顾者的有效项目（聚焦项目）转化为量身定制的、基于网络的二元形式的可行性。具体目标是：（1）测试基于网络的干预对患者和照顾者结局的初步效果；（2）检查参与者对项目的满意度；（3）确定使用基于网络的交付形式的可行性。
对癌症患者（肺癌、乳腺癌、结直肠癌、前列腺癌）及其家庭照顾者（N = 38对）进行了一项2期可行性研究。基于网络的干预提供了根据每位患者、照顾者及其二元关系的独特特征量身定制的信息和支持。主要结局是情绪困扰和生活质量。次要结局是疾病/照顾的益处、沟通、支持和自我效能感。分析包括描述性统计和重复测量方差分析。
二元组的情绪困扰显著降低，生活质量提高，并且认为疾病/照顾的益处更多。照顾者的自我效能感也有显著改善。沟通方面没有变化。参与者对项目的可用性感到满意，但建议增加更多内容。
将临床医生实施的项目转化为易于使用且对二元结局有积极影响的基于网络的形式是可行的。
基于网络的项目是一种有前景的方式，可使用较少的人员为更多患者和照顾者提供心理社会护理。它需要在更大规模的随机临床试验中进一步测试。
