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RESTORE:一项基于网络干预以增强癌症相关疲劳自我管理的探索性试验:定性过程评估结果

RESTORE: an exploratory trial of a web-based intervention to enhance self-management of cancer-related fatigue: findings from a qualitative process evaluation.

作者信息

Myall Michelle, May Carl R, Grimmett Chloe, May Christine M, Calman Lynn, Richardson Alison, Foster Claire L

机构信息

University of Southampton, Faculty of Health Sciences, Southampton, SO17 1BJ, UK.

University Hospital Southampton NHS Foundation Trust, Southampton, UK.

出版信息

BMC Med Inform Decis Mak. 2015 Nov 14;15:94. doi: 10.1186/s12911-015-0214-y.

Abstract

BACKGROUND

Cancer-related fatigue is a distressing symptom experienced by many after cancer treatment. An exploratory randomised controlled trial was conducted to test proof of concept of RESTORE: a web-based tool to enhance self-efficacy to manage cancer-related fatigue. This paper reports findings from a qualitative process evaluation to determine feasibility and acceptability of the intervention and trial processes.

METHOD

Qualitative process evaluation carried out at the end of the trial to explore participants' experiences using semi-structured telephone interviews with a purposive sample of participants from both trial arms. Normalisation Process Theory informed data collection and analysis. Analysis involved directed content analysis within a Framework Approach.

RESULTS

Nineteen participants took part. They understood the purpose and requirements of the trial and identified beneficial outcomes from taking part. For the majority, the work of the trial was easily accommodated into daily routines and did not require new skills. There were mixed views about the value of the information provided by RESTORE, depending on time since diagnosis and treatment. Personal factors, constraints of the intervention, and environmental context inhibited the integration and embedding of RESTORE into everyday life. Access to the intervention at an early stage in the treatment trajectory was important to effective utilisation, as were individual preferences for delivery of information.

CONCLUSION

The theoretical foundations of the intervention were sound. Participants derived benefits from the intervention but barriers to implementation and integration suggest that RESTORE and the trial processes require some modification before testing in a full trial.

TRIAL REGISTRATION

ISRCTN67521059 (10(th) October 2012).

摘要

背景

癌症相关疲劳是许多人在癌症治疗后经历的一种痛苦症状。开展了一项探索性随机对照试验,以检验RESTORE的概念验证:RESTORE是一种基于网络的工具,用于增强管理癌症相关疲劳的自我效能。本文报告了一项定性过程评估的结果,以确定干预措施和试验过程的可行性和可接受性。

方法

在试验结束时进行定性过程评估,通过对来自两个试验组的目标参与者样本进行半结构化电话访谈,探索参与者的体验。正常化过程理论为数据收集和分析提供了指导。分析包括在框架方法内进行定向内容分析。

结果

19名参与者参与。他们理解试验的目的和要求,并确定参与试验有有益的结果。对大多数人来说,试验工作很容易融入日常生活,不需要新技能。对于RESTORE提供的信息的价值,根据诊断和治疗后的时间不同,看法不一。个人因素、干预措施的限制以及环境背景阻碍了RESTORE融入日常生活。在治疗轨迹的早期阶段能够使用该干预措施对有效利用很重要,信息传递的个人偏好也是如此。

结论

干预措施的理论基础是合理的。参与者从干预措施中获得了益处,但实施和整合的障碍表明,在进行全面试验之前,RESTORE和试验过程需要进行一些修改。

试验注册

ISRCTN67521059(2012年10月10日)。

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