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一项针对患有晚期癌症的中国配偶照顾者及其伴侣的基于夫妻关系的综合干预措施:一项干预性研究。

A couple-based complex intervention for Chinese spousal caregivers and their partners with advanced cancer: an intervention study.

作者信息

Li Qiuping, Xu Yinghua, Zhou Huiya, Loke Alice Yuen

机构信息

Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu Province, China.

School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.

出版信息

Psychooncology. 2015 Nov;24(11):1423-31. doi: 10.1002/pon.3809. Epub 2015 Mar 23.

DOI:10.1002/pon.3809
PMID:25809351
Abstract

BACKGROUND

Guided by the Preliminary Live with Love Conceptual Framework (P-LLCF) for Cancer Couple Dyads, a Caring for Couples Coping with Cancer (4Cs) program was developed to support couples coping with cancer as a unit. This study examined the acceptability, feasibility, and the preliminary effect of the 4Cs program.

METHODS

A pre- and post-intervention study design with no control group was conducted among Chinese cancer patients and their spousal caregivers. Among the 135 couples approached, a total of 117 dyads were successfully recruited at baseline, with 92 dyads successfully followed-up at 6 weeks. Outcome measures, including dyadic mediators (self-efficacy), dyadic appraisal (Cancer Related Communication Problem, CRCP), dyadic coping (Dyadic Coping Inventory, DCI), and dyadic outcomes (physical and mental health, negative and positive emotions, and marital satisfaction), were assessed at T0 (pre-intervention) and T1 (post-intervention). Repeated measures analysis of variance was applied in testing the outcomes of the 4Cs program.

RESULTS

The recruitment and retention rates were 86.7% and 78.6%, respectively. Significant improvements were seen in the couples' scores on overall (total) self-efficacy (P < 0.01), CRCP (P < 0.05), DCI (P < 0.05), the physical component summary (PCS) of SF-12 (P < 0.05), anxiety (P < 0.01), and benefit findings (P < 0.05) from T0 to T1. Spousal caregivers scored significantly higher on self-efficacy (P < 0.05), the PCS (P < 0.01), and anxiety (P < 0.05) than the patients. The overall effect sizes calculated in this study ranged from medium to small.

CONCLUSIONS

This study provides evidence suggesting that the 4Cs program is acceptable, feasible, and improved outcomes in supporting Chinese couples coping with cancer as dyads.

摘要

背景

在癌症夫妻二元组的初步“带着爱生活”概念框架(P - LLCF)的指导下,开发了一个关爱夫妻应对癌症(4C)项目,以支持夫妻作为一个整体应对癌症。本研究考察了4C项目的可接受性、可行性及初步效果。

方法

在中国癌症患者及其配偶照顾者中进行了一项无对照组的干预前后研究设计。在接触的135对夫妻中,共有117对在基线时成功招募,92对在6周时成功随访。在T0(干预前)和T1(干预后)评估结果指标,包括二元中介变量(自我效能感)、二元评估(癌症相关沟通问题,CRCP)、二元应对(二元应对量表,DCI)以及二元结果(身心健康、消极和积极情绪、婚姻满意度)。采用重复测量方差分析来检验4C项目的结果。

结果

招募率和保留率分别为86.7%和78.6%。从T0到T1,夫妻在总体(总)自我效能感(P < 0.01)、CRCP(P < 0.05)、DCI(P < 0.05)、SF - 12的身体成分总结(PCS)(P < 0.05)、焦虑(P < 0.01)以及获益感(P < 0.05)方面的得分有显著改善。配偶照顾者在自我效能感(P < 0.05)、PCS(P < 0.01)和焦虑(P < 0.05)方面的得分显著高于患者。本研究计算的总体效应大小从中等到小。

结论

本研究提供的证据表明,4C项目在支持中国夫妻作为二元组应对癌症方面是可接受的、可行的且能改善结果。

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