Titler Marita G, Visovatti Moira A, Shuman Clayton, Ellis Katrina R, Banerjee Tanima, Dockham Bonnie, Yakusheva Olga, Northouse Laurel
Department of Systems, Populations and Leadership, University of Michigan School of Nursing, 400 North Ingalls Street, Room 4170, Ann Arbor, MI, 48109-5482, USA.
Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, 400 North Ingalls Street, Room 2185, Ann Arbor, MI, 48109-5482, USA.
Support Care Cancer. 2017 Nov;25(11):3395-3406. doi: 10.1007/s00520-017-3758-9. Epub 2017 Jun 13.
This study examined the effectiveness, feasibility, and satisfaction with implementation of the FOCUS program in two US Cancer Support Community affiliates in Ohio and California as well as the cost to deliver the program. FOCUS is an evidence-based psychoeducational intervention for dyads (cancer patients and caregivers).
A pre-post-intervention design was employed. Eleven, five-session Focus programs were delivered by licensed professionals in a small group format (three-four dyads/group) to 36 patient-caregiver dyads. An Implementation Training Manual, a FOCUS Intervention Protocol Manual, and weekly conference calls were used to foster implementation. Participants completed questionnaires prior to and following completion of each five-session FOCUS program to measure primary (emotional distress, quality of life) and secondary outcomes (benefits of illness, self-efficacy, and dyadic communication). Enrollment and retention rates and fidelity to FOCUS were used to measure feasibility. Cost estimates were based on time and median hourly wages. Repeated analysis of variance was used to analyze the effect of FOCUS on outcomes for dyads. Descriptive statistics were used to examine feasibility, satisfaction, and cost estimates.
FOCUS had positive effects on QOL (p = .014), emotional (p = .012), and functional (p = .049) well-being, emotional distress (p = .002), benefits of illness (p = .013), and self-efficacy (p = .001). Intervention fidelity was 85% with enrollment and retention rates of 71.4 and 90%, respectively. Participants were highly satisfied. Cost for oversight and delivery of the five-session FOCUS program was $168.00 per dyad.
FOCUS is an economic and effective intervention to decrease distress and improve the quality of life for dyads.
本研究考察了“聚焦”项目在美国俄亥俄州和加利福尼亚州的两家癌症支持社区分支机构实施的有效性、可行性和满意度，以及该项目的实施成本。“聚焦”是一项针对二元组（癌症患者及其护理者）的循证心理教育干预措施。
采用干预前后设计。由持牌专业人员以小组形式（每组三至四个二元组）为36个患者-护理者二元组提供了11个为期五节的“聚焦”项目。使用《实施培训手册》《聚焦干预方案手册》以及每周的电话会议来促进项目实施。参与者在每个为期五节的“聚焦”项目结束之前和之后完成问卷，以测量主要结果（情绪困扰、生活质量）和次要结果（疾病益处、自我效能感和二元沟通）。使用参与率和留存率以及对“聚焦”项目的依从性来衡量可行性。成本估计基于时间和小时工资中位数。采用重复方差分析来分析“聚焦”项目对二元组结果的影响。使用描述性统计来考察可行性、满意度和成本估计。
“聚焦”项目对生活质量（p = 0.014）、情绪（p = 0.012）和功能（p = 0.049）幸福感、情绪困扰（p = 0.002）、疾病益处（p = 0.013）和自我效能感（p = 0.001）产生了积极影响。干预依从性为85%，参与率和留存率分别为71.4%和90%。参与者满意度很高。监督和实施为期五节的“聚焦”项目的成本为每个二元组168.00美元。
“聚焦”项目是一种经济有效的干预措施，可减少二元组的困扰并改善其生活质量。
