Sun Virginia, Grant Marcia, Koczywas Marianna, Freeman Bonnie, Zachariah Finly, Fujinami Rebecca, Del Ferraro Catherine, Uman Gwen, Ferrell Betty
Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California.
Medical Oncology and Therapeutics Research, City of Hope, Duarte, California.
Cancer. 2015 Oct 15;121(20):3737-45. doi: 10.1002/cncr.29567. Epub 2015 Jul 6.
Family caregivers (FCGs) experience significant deteriorations in quality of life while caring for patients with lung cancer. In this study, the authors tested the effectiveness of an interdisciplinary palliative care intervention for FCGs of patients diagnosed with stage I through IV nonsmall cell lung cancer.
FCGs who were identified by patients as their primary caregivers were enrolled in a prospective, quasi-experimental study in which the usual care group was accrued first followed by the intervention group. FCGs in the intervention group were presented at interdisciplinary care meetings, and they also received 4 educational sessions organized in the physical, psychological, social, and spiritual domains. The sessions included self-care plans to support the FCG's own needs. Caregiver burden, caregiving skills preparedness, psychological distress, and FCG quality of life were assessed at baseline and after 12 weeks using validated measures.
In total, 366 FCGs were included in the primary analysis. FCGs who received the interdisciplinary palliative care intervention had significantly better scores for social well being (5.84 vs 6.86; P < .001) and had lower psychological distress scores (4.61 vs 4.20; P = .010) at 12 weeks compared with FCGs in the usual care group. FCGs in the intervention group also had significantly less caregiver burden compared with FCGs in the usual care group (P = .008).
An interdisciplinary approach to palliative care in lung cancer resulted in statistically significant improvements in FCG's social well being and psychological distress and in less caregiver burden.
家庭照顾者在照顾肺癌患者时生活质量显著下降。在本研究中,作者测试了一种跨学科姑息治疗干预措施对诊断为I期至IV期非小细胞肺癌患者的家庭照顾者的有效性。
由患者确定为其主要照顾者的家庭照顾者被纳入一项前瞻性、准实验性研究,其中先招募常规护理组,然后是干预组。干预组的家庭照顾者参加跨学科护理会议,他们还接受了在身体、心理、社会和精神领域组织的4次教育课程。这些课程包括支持家庭照顾者自身需求的自我护理计划。在基线和12周后使用经过验证的测量方法评估照顾者负担、照顾技能准备情况、心理困扰和家庭照顾者的生活质量。
共有366名家庭照顾者纳入主要分析。与常规护理组的家庭照顾者相比,接受跨学科姑息治疗干预的家庭照顾者在12周时的社会幸福感得分显著更高(5.84对6.86;P <.001),心理困扰得分更低(4.61对4.20;P =.010)。与常规护理组的家庭照顾者相比,干预组的家庭照顾者照顾者负担也显著减轻(P =.008)。
肺癌姑息治疗的跨学科方法在家庭照顾者的社会幸福感、心理困扰方面有统计学上的显著改善,且照顾者负担减轻。