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基于网络主动干预与电话干预的信息与支持随机对照试验方案:电子平台能否为肺癌患者提供有效护理?

Protocol for a Randomized Controlled Trial of Proactive Web-Based Versus Telephone-Based Information and Support: Can Electronic Platforms Deliver Effective Care for Lung Cancer Patients?

作者信息

Paul Christine L, Boyes Allison W, O'Brien Lorna, Baker Amanda L, Henskens Frans A, Roos Ian, Clinton-McHarg Tara, Bellamy Douglas, Colburn Glenda, Rose Shiho, Cox Martine E, Fradgley Elizabeth A, Baird Hannah, Barker Daniel

机构信息

Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.

出版信息

JMIR Res Protoc. 2016 Oct 26;5(4):e202. doi: 10.2196/resprot.6248.

Abstract

BACKGROUND

Community-based services such as telephone support lines can provide valuable informational, emotional, and practical support for cancer patients via telephone- or Web-based (live chat or email) platforms. However, very little rigorous research has examined the efficacy of such services in improving patient outcomes.

OBJECTIVE

This study will determine whether: proactive telephone or Web-delivered support produces outcomes superior to printed information; and Web-delivered support produces outcomes comparable to telephone support.

METHODS

A consecutive sample of 501 lung cancer outpatients will be recruited from 50 Australian health services to participate in a patient-randomized controlled trial (RCT). Eligible individuals must: be 18 years or older; have received a lung cancer diagnosis (including mesothelioma) within the previous 4 months; have an approximate life expectancy of at least 6 months; and have Internet access. Participants will be randomly allocated to receive: (1) an information booklet, (2) proactive telephone support, or (3) proactive Web support, chat, and/or email. The primary patient outcomes will be measured by the General Health Questionnaire (GHQ-12) and Health Education and Impact Questionnaire (heiQ) at 3 and 6 months post recruitment. The acceptability of proactive recruitment strategies will also be assessed.

RESULTS

It is hypothesized that participants receiving telephone or Web support will report reduced distress (GHQ-12 scores that are 0.3 standard deviations (SD) lower) and greater self-efficacy (heiQ scores that are 0.3 SDs higher) than participants receiving booklets. Individuals receiving Web support will report heiQ scores within 0.29 SDs of individuals receiving telephone support.

CONCLUSIONS

If proven effective, electronic approaches such as live-chat and email have the potential to increase the accessibility and continuity of supportive care delivered by community-based services. This evidence may also inform the redesigning of helpline-style services to be effective and responsive to patient needs.

摘要

背景

诸如电话支持热线等基于社区的服务可以通过电话或基于网络的(实时聊天或电子邮件)平台为癌症患者提供有价值的信息、情感和实际支持。然而,很少有严谨的研究考察过此类服务在改善患者预后方面的效果。

目的

本研究将确定:主动提供的电话或网络支持是否能产生优于印刷信息的效果;以及网络提供的支持是否能产生与电话支持相当的效果。

方法

将从50家澳大利亚医疗服务机构中连续抽取501名肺癌门诊患者作为样本,参与一项患者随机对照试验(RCT)。符合条件的个体必须:年满18岁;在过去4个月内被诊断为肺癌(包括间皮瘤);预期寿命至少为6个月;并且能够上网。参与者将被随机分配接受:(1)一本信息手册,(2)主动电话支持,或(3)主动网络支持、聊天和/或电子邮件。主要的患者结局将在招募后3个月和6个月时通过一般健康问卷(GHQ - 12)和健康教育与影响问卷(heiQ)进行测量。还将评估主动招募策略的可接受性。

结果

假设接受电话或网络支持的参与者比接受手册的参与者报告的痛苦程度更低(GHQ - 12得分低0.3个标准差(SD))且自我效能感更高(heiQ得分高0.3个标准差)。接受网络支持的个体报告的heiQ得分将在接受电话支持个体的0.29个标准差范围内。

结论

如果被证明有效,诸如实时聊天和电子邮件等电子方式有可能提高基于社区的服务所提供的支持性护理的可及性和连续性。这一证据也可能为重新设计热线式服务以使其有效并满足患者需求提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdc0/5103105/96d4838315cf/resprot_v5i4e202_fig1.jpg

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