Chambers Suzanne Kathleen, Girgis Araf, Occhipinti Stefano, Hutchison Sandy, Turner Jane, McDowell Michelle, Mihalopoulos Cathrine, Carter Robert, Dunn Jeffrey Charles
Griffith Health Institute, Griffith University in Gold Coast, Queensland, Australia.
Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, Australia.
Oncol Nurs Forum. 2014 Jul 1;41(4):E256-66. doi: 10.1188/14.ONF.E256-E266.
PURPOSE/OBJECTIVES: To compare the effectiveness of two low-intensity approaches for distressed patients with cancer and caregivers who had called cancer helplines seeking support. Baseline distress was hypothesized as a moderator of intervention effect.
Randomized trial.
Community-based cancer helplines in Queensland and New South Wales, Australia.
354 patients with cancer and 336 caregivers.
Participants were randomized to either a single session of nurse-led self-management intervention or a five-session psychologist cognitive behavioral intervention delivered by telephone. Assessments were undertaken at baseline (preintervention) and at 3, 6, and 12 months.
Psychological and cancer-specific distress and post-traumatic growth.
No significant moderation by baseline cancer-specific distress was noted. For low-education patients, only the psychologist intervention was associated with a significant drop in distress. For all other participants, distress decreased over time in both arms with small to large effect sizes (Cohen's ds = 0.05-0.82). Post-traumatic growth increased over time for all participants (Cohen's ds = 0.6-0.64).
Many distressed patients with cancer and their caregivers may benefit significantly from a single session of a nurse psychoeducation intervention that can be delivered remotely by telephone and supported by self-management materials. Research is needed to develop an algorithm that moves beyond the use of distress as the only indicator for referral to specialist psychological services. Survivors and caregivers with low education and low literacy may require more in-depth and targeted support.
Brief nurse psychoeducation and stress management for cancer survivors and caregivers should be considered as part of a tiered approach to psychosocial care.
目的/目标：比较两种低强度方法对拨打癌症求助热线寻求支持的癌症患者及其护理人员的效果。假设基线困扰是干预效果的调节因素。
随机试验。
澳大利亚昆士兰州和新南威尔士州的社区癌症求助热线。
354名癌症患者和336名护理人员。
参与者被随机分为接受由护士主导的单次自我管理干预或通过电话进行的为期五节的心理学家认知行为干预。在基线（干预前）、3个月、6个月和12个月时进行评估。
心理困扰、癌症特异性困扰和创伤后成长。
未发现基线癌症特异性困扰有显著调节作用。对于低教育程度的患者，只有心理学家干预与困扰显著下降有关。对于所有其他参与者，两组的困扰都随时间下降，效应大小从小到中（科恩d值=0.05-0.82）。所有参与者的创伤后成长都随时间增加（科恩d值=0.6-0.64）。
许多困扰的癌症患者及其护理人员可能会从单次护士心理教育干预中显著受益，这种干预可以通过电话远程提供并辅以自我管理材料。需要开展研究以开发一种算法，超越仅将困扰作为转介至专业心理服务的唯一指标。低教育程度和低识字率的幸存者及护理人员可能需要更深入、有针对性的支持。
应为癌症幸存者和护理人员提供简短的护士心理教育和压力管理，这应被视为心理社会护理分层方法的一部分。
