Poort Hanneke, Meade Cathy D, Knoop Hans, Gielissen Marieke F M, Pinilla-Ibarz Javier, Jacobsen Paul B
Author Affiliations: Expert Center for Chronic Fatigue, Radboud University Medical Center, Nijmegen, the Netherlands (Ms Poort and Drs Knoop and Gielissen); Division of Population Science, Department of Health Outcomes and Behavior (Drs Meade and Jacobsen), Department of Malignant Hematology (Dr Pinilla-Ibarz), H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida; Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (Drs Knoop and Gielissen).
Cancer Nurs. 2018 Jan/Feb;41(1):E28-E37. doi: 10.1097/NCC.0000000000000446.
Fatigue is one of the most important quality of life issues experienced by patients being treated with oral targeted therapy for chronic myeloid leukemia (CML). However, no intervention exists that specifically addresses strategies to reduce targeted therapy-related fatigue.
This study adapted an evidence-based clinic-delivered intervention (EBI) "cognitive behavior therapy for post-cancer fatigue" for use in CML patients. The existing EBI was based on 6 established perpetuating factors of fatigue (ie, sleep, activity, helpful thinking, coping with cancer, social support, and fear of disease recurrence). Study aims were to gauge reactions to (1) existing content and (2) a new Internet-assisted intervention delivery format.
Guided by the ADAPT-ITT framework, we used a series of systematic steps and adaptation methodologies, including semistructured interviews with CML patients and providers and feedback from topical experts.
Patients were receptive to existing content topics and an Internet-assisted delivery format was acceptable. A key theme reflected the need for a new customized psychoeducational module about CML as a disease and its treatment. Both providers and patients held positive views about the potential of the adapted EBI to improve fatigue.
Findings offered essential guidance for the adaptation and reinforced the utility of the adapted intervention.
Adapting existing EBIs for new audiences contributes to advancing findings of evidence-based research, ultimately providing nurses and other healthcare providers with important referral options to interventions that may provide useful strategies to improve quality of life and reduce targeted therapy-related fatigue.
疲劳是接受慢性粒细胞白血病（CML）口服靶向治疗的患者所经历的最重要的生活质量问题之一。然而，目前尚无专门针对减少靶向治疗相关疲劳的干预措施。
本研究采用了一种基于证据的临床干预措施（EBI）“癌症后疲劳认知行为疗法”，用于CML患者。现有的EBI基于6个已确定的疲劳持续因素（即睡眠、活动、有益思维、应对癌症、社会支持和对疾病复发的恐惧）。研究目的是评估对（1）现有内容和（2）一种新的互联网辅助干预交付形式的反应。
在ADAPT-ITT框架的指导下，我们使用了一系列系统步骤和改编方法，包括对CML患者和提供者的半结构化访谈以及主题专家的反馈。
患者接受现有内容主题，互联网辅助交付形式是可接受的。一个关键主题反映了需要一个关于CML作为一种疾病及其治疗的新的定制心理教育模块。提供者和患者对改编后的EBI改善疲劳的潜力都持积极看法。
研究结果为改编提供了重要指导，并强化了改编后干预措施的效用。
为新受众改编现有的EBI有助于推进循证研究的结果，最终为护士和其他医疗保健提供者提供重要的转诊选择，以采用可能提供有用策略来改善生活质量和减少靶向治疗相关疲劳的干预措施。
