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一项关于基于网络的交互式干预措施“癌症应对”的随机对照试验的研究方案。

A study protocol for a randomised controlled trial of an interactive web-based intervention: CancerCope.

作者信息

Chambers Suzanne K, Ritterband Lee, Thorndike Frances, Nielsen Lisa, Aitken Joanne F, Clutton Samantha, Scuffham Paul, Youl Philippa, Morris Bronwyn, Baade Peter, Dunn Jeffrey

机构信息

Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.

Cancer Council Queensland, Brisbane, Australia.

出版信息

BMJ Open. 2017 Jun 23;7(6):e017279. doi: 10.1136/bmjopen-2017-017279.

Abstract

INTRODUCTION

Approximately 35% of patients with cancer experience clinically significant distress, and unmet psychological supportive care needs are prevalent. This study describes the protocol for a randomised controlled trial (RCT) to assess the efficacy and cost-effectiveness of an internet-based psychological intervention for distressed patients with cancer.

METHODS AND ANALYSIS

In phase I, the intervention was developed on an interactive web platform and pilot tested for acceptability using a qualitative methodology with 21 patients with cancer. Phase II is an RCT underway with patients with or at risk of elevated psychological distress comparing: (1) static patient education website with (2) individualised web-delivered cognitive behavioural intervention (CancerCope). Participants were recruited through the Queensland Cancer Registry and Cancer Council Helpline and met the following inclusion criteria: (1) recently diagnosed with cancer; (2) able to read and speak English; (3) no previous history of head injury, dementia or psychiatric illness; (4) no other concurrent cancer; (5) phone and internet access; (5) scored ≥4 on the Distress Thermometer. Participants are assessed at four time points: baseline/recruitment and 2, 6 and 12 months after recruitment and intervention commencement. Of the 163 participants recruited, 50% met caseness for distress. The area of highest unmet supportive care needs were psychological followed by physical and daily living needs. Primary outcomes are psychological and cancer-specific distress and unmet psychological supportive care needs. Secondary outcomes are positive adjustment, quality of life and cost-effectiveness.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the Griffith University Human Research Ethics Committee (Approval: PSY/70/13/HREC) and the Metro South Human Research Ethics Committee (HREC/13/QPAH/601). All participants provide informed consent prior to taking part in the study. Once completed, this study will provide recommendations about the efficacy of web-based cognitive behavioural interventions to facilitate better psychosocial adjustment for people with cancer.

TRIAL REGISTRATION NUMBER

ANZCTR (ACTRN12613001026718).

摘要

引言

约35%的癌症患者经历临床上显著的痛苦,未满足的心理支持护理需求普遍存在。本研究描述了一项随机对照试验(RCT)的方案,以评估基于互联网的心理干预对痛苦的癌症患者的疗效和成本效益。

方法与分析

在第一阶段,干预措施在一个交互式网络平台上开发,并使用定性方法对21名癌症患者进行了可接受性的预试验。第二阶段是一项正在进行的随机对照试验,对有心理困扰或有心理困扰风险的患者进行比较:(1)静态患者教育网站与(2)个性化网络认知行为干预(CancerCope)。通过昆士兰癌症登记处和癌症理事会帮助热线招募参与者,他们符合以下纳入标准:(1)最近被诊断患有癌症;(2)能够阅读和说英语;(3)无头部受伤、痴呆或精神疾病史;(4)无其他并发癌症;(5)有电话和互联网接入;(5)在痛苦温度计上得分≥4分。在四个时间点对参与者进行评估:基线/招募时以及招募和干预开始后2、6和12个月。在招募的163名参与者中,50%符合痛苦病例标准。未满足的支持护理需求最高的领域是心理需求,其次是身体和日常生活需求。主要结局是心理和癌症特异性痛苦以及未满足的心理支持护理需求。次要结局是积极调整、生活质量和成本效益。

伦理与传播

获得了格里菲斯大学人类研究伦理委员会(批准号:PSY/70/13/HREC)和南地铁人类研究伦理委员会(HREC/13/QPAH/601)的伦理批准。所有参与者在参与研究前均提供知情同意书。本研究一旦完成,将提供关于基于网络的认知行为干预疗效的建议,以促进癌症患者更好的心理社会调整。

试验注册号

ANZCTR(ACTRN12613001026718)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b5e/5541614/738e5a8a0703/bmjopen-2017-017279f01.jpg

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