向患者介绍早期姑息治疗研究是否会增加其对门诊姑息性癌症护理的偏好？“增强力量”项目的研究结果。
Does educating patients about the Early Palliative Care Study increase preferences for outpatient palliative cancer care? Findings from Project EMPOWER.
作者信息
Hoerger Michael, Perry Laura M, Gramling Robert, Epstein Ronald M, Duberstein Paul R
机构信息
Department of Psychology.
Department of Family Medicine, University of Vermont Medical Center.
出版信息
Health Psychol. 2017 Jun;36(6):538-548. doi: 10.1037/hea0000489. Epub 2017 Mar 9.
OBJECTIVES
Randomized controlled trials, especially the Early Palliative Care Study (Temel et al., 2010), have shown that early outpatient palliative cancer care can improve quality of life for patients with advanced cancer or serious symptoms. However, fear and misconceptions drive avoidance of palliative care. Drawing from an empowerment perspective, we examined whether educating patients about evidence from the Early Palliative Care Study would increase preferences for palliative care.
METHOD
A sample of 598 patients with prostate, breast, lung, colon/rectal, skin, and other cancer diagnoses completed an Internet-mediated experiment using a between-group prepost design. Intervention participants received a summary of the Early Palliative Care Study; controls received no intervention. Participants completed baseline and posttest assessments of preferences of palliative care. Analyses controlled for age, gender, education, cancer type, presence of metastases, time since diagnosis, and baseline preferences.
RESULTS
As hypothesized, the intervention had a favorable impact on participants' preferences for outpatient palliative cancer care relative to controls (d = 1.01, p < .001), while controlling for covariates. Intervention participants came to view palliative care as more efficacious (d = 0.79, p < .001) and less scary (d = 0.60, p < .001) and exhibited stronger behavioral intentions to utilize outpatient palliative care if referred (d = 0.60, p < .001). Findings were comparable in patients with metastatic disease, those with less education, and those experiencing financial strain.
CONCLUSIONS
Educating patients about the Early Palliative Care Study increases preferences for early outpatient palliative care. This research has implications for future studies aimed at improving quality of life in cancer by increasing palliative care utilization. (PsycINFO Database Record
目标
随机对照试验，尤其是早期姑息治疗研究（特梅尔等人，2010年）表明，早期门诊姑息性癌症护理可以提高晚期癌症或有严重症状患者的生活质量。然而，恐惧和误解导致人们回避姑息治疗。从赋权的角度出发，我们研究了向患者介绍早期姑息治疗研究的证据是否会增加他们对姑息治疗的偏好。
方法
598名被诊断患有前列腺癌、乳腺癌、肺癌、结肠/直肠癌、皮肤癌和其他癌症的患者样本，采用组间前后测设计完成了一项基于互联网的实验。干预组参与者收到了早期姑息治疗研究的摘要；对照组未接受干预。参与者完成了对姑息治疗偏好的基线和后测评估。分析控制了年龄、性别、教育程度、癌症类型、转移情况、确诊时间和基线偏好。
结果
正如假设的那样，在控制协变量的情况下，与对照组相比，干预对参与者对门诊姑息性癌症护理的偏好产生了有利影响（d = 1.01，p < .001）。干预组参与者开始认为姑息治疗更有效（d = 0.79，p < .001）且不那么可怕（d = 0.60，p < .001），并且如果被转诊，表现出更强的使用门诊姑息治疗的行为意向（d = 0.60，p < .001）。在患有转移性疾病的患者、教育程度较低的患者和面临经济压力的患者中，研究结果具有可比性。
结论
向患者介绍早期姑息治疗研究可增加对早期门诊姑息治疗的偏好。这项研究对未来旨在通过增加姑息治疗的使用来改善癌症患者生活质量的研究具有启示意义。（《心理学文摘数据库记录》
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