Mahendran Rathi, Lim Haikel A, Tan Joyce Y S, Ng Hui Ying, Chua Joanne, Lim Siew Eng, Kua Ee Heok, Griva Konstadina
Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
Health Qual Life Outcomes. 2017 Jan 23;15(1):17. doi: 10.1186/s12955-017-0595-y.
Family caregivers of cancer patients often experience an impaired quality of life (QOL) and emotional distress as a result of their caregiving duties, which may potentially influence the quality of care of their care recipients. The COPE (Caregivers of cancer Outpatients' Psycho-Education support group therapy) intervention was developed as a response to the lack of work done among family caregivers of ambulatory cancer patients in Asia. This group intervention comprised four weekly sessions simultaneously targeting psychoeducation, skills training, and supportive therapy. The present study sought to evaluate the pilot COPE intervention using both quantitative and qualitative measures. The Hospital Anxiety and Depression Scale (HADS) was used to measure both depression and anxiety, while the Caregiver QOL - Cancer (CQOLC) measured caregiver QOL. These instruments were measured at baseline pre-intervention, and immediately post-intervention. A waitlist control group design was adopted. A subset of caregivers from the intervention group were invited for a semi-structured interview post-intervention.
Quantitative analyses suggest that while QOL remained stable in control group participants, intervention group participants experienced QOL improvements - both in overall QOL and in the specific domain of burden. There were no significant differences in the trajectories of depression and anxiety in both groups. Qualitative analyses suggest that this might have been a result of the intervention not only equipping participants with the relevant coping skills, but also providing a platform for emotional expression and situational reappraisal.
The COPE intervention has shown some efficacy in helping family caregivers of cancer patients, but more work is required before this can be implemented.
Current Controlled Trials NCT02120183 . Registered 17 April 2014. Retrospectively registered.
癌症患者的家庭照护者常常因照护职责而生活质量受损、情绪困扰，这可能会对其照护对象的护理质量产生潜在影响。作为对亚洲门诊癌症患者家庭照护者相关工作不足的回应，开发了COPE（癌症门诊患者照护者心理教育支持小组疗法）干预措施。该小组干预包括四个每周一次的疗程，同时针对心理教育、技能培训和支持性疗法。本研究旨在使用定量和定性方法评估COPE干预试点。采用医院焦虑抑郁量表（HADS）测量抑郁和焦虑，同时使用照护者癌症生活质量量表（CQOLC）测量照护者的生活质量。这些工具在干预前基线、干预后立即进行测量。采用等待名单对照组设计。干预组的一部分照护者在干预后被邀请参加半结构化访谈。
定量分析表明，虽然对照组参与者的生活质量保持稳定，但干预组参与者的生活质量有所改善——在总体生活质量和负担这一特定领域均有改善。两组抑郁和焦虑的轨迹没有显著差异。定性分析表明，这可能是由于干预不仅使参与者具备了相关应对技能，还提供了一个情感表达和情境重新评估的平台。
COPE干预在帮助癌症患者家庭照护者方面已显示出一定疗效，但在实施之前还需要做更多工作。
当前受控试验NCT02120183。2014年4月17日注册。回顾性注册。
