Beatty Lisa, Binnion Claire, Kemp Emma, Koczwara Bogda
School of Psychology, Flinders University, Adelaide, Australia.
Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, Australia.
Support Care Cancer. 2017 Aug;25(8):2539-2548. doi: 10.1007/s00520-017-3663-2. Epub 2017 Mar 15.
This study qualitatively explored barriers and facilitators of adherence to an online psychological intervention for cancer-related distress.
Semi-structured interviews were conducted with 13 adults with cancer, randomised to receive either a 6-week intervention (n = 8) or attention control (n = 5) as part of a larger RCT. Transcripts were coded for themes and subthemes, and recruitment ceased when saturation of themes occurred.
Adherence overall was high: six participants completed all six modules, three completed five modules, two completed four modules, one completed one module, and one did not access the program. The total numbers of barriers (n = 19) and facilitators (n = 17) identified were equivalent and were categorised into five overarching themes: illness factors, psychological factors, personal factors, intervention factors and computer factors. However, the prevalence with which themes were discussed differed: illness factors (specifically cancer treatment side effects) were the main reported barrier to adherence; intervention factors (email reminders, program satisfaction, ease of use, program content) were the most common facilitators.
While some factors were cited as both facilitating and barring adherence, and therefore reflective of personal preferences and circumstances, a number of recommendations were derived regarding (i) the best timing for online interventions and (ii) the need for multi-platform programs.
本研究定性探讨了影响癌症相关痛苦在线心理干预依从性的障碍和促进因素。
对13名成年癌症患者进行了半结构化访谈,这些患者作为一项更大规模随机对照试验的一部分,被随机分配接受为期6周的干预(n = 8)或注意力控制组(n = 5)。对访谈记录进行编码以确定主题和子主题,当主题饱和时停止招募。
总体依从性较高:6名参与者完成了所有6个模块,3名完成了5个模块,2名完成了4个模块,1名完成了1个模块,1名未访问该项目。确定的障碍(n = 19)和促进因素(n = 17)总数相当,并分为五个总体主题:疾病因素、心理因素、个人因素、干预因素和计算机因素。然而,各主题的讨论频率有所不同:疾病因素(特别是癌症治疗副作用)是报告的依从性主要障碍;干预因素(电子邮件提醒、项目满意度、易用性、项目内容)是最常见的促进因素。
虽然一些因素被认为既促进又阻碍依从性,因此反映了个人偏好和情况,但针对(i)在线干预的最佳时机和(ii)多平台项目的需求提出了一些建议。