Tsianakas V, Robert G, Richardson A, Verity R, Oakley C, Murrells T, Flynn M, Ream E
Florence Nightingale Faculty of Nursing and Midwifery, King's College London, 57 Waterloo Road, London, SE1 8WA, UK.
Support Care Cancer. 2015 Oct;23(10):3069-80. doi: 10.1007/s00520-015-2677-x. Epub 2015 Mar 6.
Supporting someone through chemotherapy can be emotionally and physically demanding. However, research has yet to establish the type of support carers require or the best way to provide this. This study tested the feasibility and acceptability of a complex intervention for carers that was co-designed by staff and carers of patients starting chemotherapy.
Forty-seven carers were recruited, randomised between the intervention (n = 24) and control (n = 23) groups. A questionnaire was completed pre- and post-intervention measuring knowledge of chemotherapy and its side effects, experience of care, satisfaction with outpatient services, coping and emotional wellbeing. The intervention process was evaluated by carers and healthcare professionals (HCPs) in focus groups.
Recruitment to the study was unproblematic and attrition from it was low, suggesting the intervention and study processes were acceptable to patients and carers. Carers in receipt of the 'Take Care' intervention reported statistically significantly better understanding of symptoms and side effects and their information needs being more frequently met than carers in the control. Confidence in coping improved between baseline and follow-up for the intervention group and declined for the control although differences were insufficient to achieve statistical significance. There was no significant difference between the two groups' emotional wellbeing. HCP and carer focus groups confirmed the feasibility and acceptability of the intervention.
The 'Take Care' intervention proved acceptable to carers and HCPs and demonstrates considerable promise and utility in practice. Study findings support the conduct of a fully powered RCT to determine the intervention's effectiveness and cost-effectiveness.
在化疗过程中为他人提供支持对照顾者来说在情感和身体上都要求很高。然而，研究尚未确定照顾者所需的支持类型或提供这种支持的最佳方式。本研究测试了一种由开始化疗患者的工作人员和照顾者共同设计的针对照顾者的复杂干预措施的可行性和可接受性。
招募了47名照顾者，随机分为干预组（n = 24）和对照组（n = 23）。在干预前后完成一份问卷，测量对化疗及其副作用的了解、护理经验、对门诊服务的满意度、应对方式和情绪健康状况。通过焦点小组让照顾者和医疗保健专业人员（HCPs）对干预过程进行评估。
该研究的招募工作没有问题，退出率很低，这表明干预措施和研究过程为患者和照顾者所接受。接受“关爱”干预的照顾者报告称，在对症状和副作用的理解方面，统计学上显著优于对照组，他们的信息需求也更频繁地得到满足。干预组在基线和随访之间应对能力的信心有所提高，而对照组则有所下降，尽管差异不足以达到统计学显著性。两组在情绪健康方面没有显著差异。HCP和照顾者焦点小组证实了该干预措施的可行性和可接受性。
“关爱”干预措施被证明为照顾者和HCPs所接受，并在实践中显示出相当大的前景和实用性。研究结果支持开展一项充分有力的随机对照试验，以确定该干预措施的有效性和成本效益。
