Community and Behavioral Health, Colorado School of Public Health , Aurora, CO , USA.
Carilion Clinic, Virginia Tech Carilion School of Medicine , Roanoke, VA , USA.
Front Public Health. 2015 Apr 27;2:214. doi: 10.3389/fpubh.2014.00214. eCollection 2014.
Self-management has been identified as an important opportunity to improve health outcomes among cancer survivors. However, few evidence-based interventions are available to meet this need.
The effectiveness of an adapted version of the Chronic Disease Self-Management Program for cancer survivors called Cancer Thriving and Surviving was evaluated in a randomized trial. Outcomes were assessed at baseline and 6-months post program via written survey among 244 participants in Colorado. Repeated measures analysis was used to analyze pre/post program change.
Statistically significant improvement was observed among those in the intervention in the following outcomes: Provider communication (+16.7% change); depression (-19.1%); energy (+13.8%); sleep (-24.9%) and stress-related problems (-19.2%); change over time was also observed in the controls for energy, sleep, and stress-related outcomes though to a lesser degree. Effect sizes of the difference in change over time observed indicate a net beneficial effect for provider communication (0.23); and decreases in depression (-0.18); pain (-0.19); problems related to stress (-0.17); and sleep (-0.20).
Study data suggest that the self-management support from adaptation of the CDSMP can reach and appeal to cancer survivors, improves common concerns in this population, and can fill an important gap in meeting the ongoing need for management of post-diagnosis issues in this growing segment of the U.S. population.
自我管理已被确定为改善癌症幸存者健康结果的重要机会。然而,满足这一需求的循证干预措施很少。
对一种名为“癌症生存与繁荣”的经过改编的慢性病自我管理计划(CDSMP)在科罗拉多州的 244 名参与者中进行了随机试验,评估了其对癌症幸存者的有效性。通过书面调查在基线和 6 个月后评估结果。使用重复测量分析来分析方案前后的变化。
干预组在以下方面观察到统计学上显著的改善:与提供者的沟通(+16.7%的变化);抑郁(-19.1%);能量(+13.8%);睡眠(-24.9%)和与压力相关的问题(-19.2%);对照组在能量、睡眠和与压力相关的结果方面也观察到了时间变化,但程度较小。观察到的随时间变化的差异的效应大小表明,与提供者的沟通(0.23)有净有益效果;抑郁(-0.18);疼痛(-0.19);与压力相关的问题(-0.17);和睡眠(-0.20)。
研究数据表明,CDSMP 的自我管理支持可以覆盖并吸引癌症幸存者,改善这一人群的常见问题,并可以填补满足美国这一不断增长人群诊断后问题管理需求的重要空白。