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早期治疗期间肺癌会诊中高级实践护理的可行性:一项II期研究。

Feasibility of advanced practice nursing in lung cancer consultations during early treatment: A phase II study.

作者信息

Serena Andrea, Dwyer Andrew, Peters Solange, Eicher Manuela

机构信息

Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Switzerland; University of Applied Sciences and Arts Western Switzerland, School of Health Fribourg, Fribourg, Switzerland; Department of Oncology, Lausanne University Hospital, Switzerland.

Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Switzerland.

出版信息

Eur J Oncol Nurs. 2017 Aug;29:106-114. doi: 10.1016/j.ejon.2017.05.007. Epub 2017 Jun 12.

Abstract

PURPOSE

There are limited data on the effectiveness of Advanced Practice Nurses in Lung Cancer (APNLC). Previous studies have demonstrated barriers to investigation including low recruitment and high attrition rates in lung cancer population. The primary aim of this study was to assess the feasibility of APNLC consultations and the ability to collect patient-reported outcome measures (PROMs) during first-line treatment. The secondary aim was to describe changes in self-efficacy for managing lung cancer-related symptoms, symptom intensity/burden and unmet supportive care needs of APNLC patients during first-line treatment.

METHODS

An exact single-stage phase II design was applied. We recruited a consecutive sample of newly diagnosed lung cancer patients receiving systemic treatment in a Swiss oncology outpatient center. The intervention consisted of four systematic, alternating face-to-face/telephone consultations during first line-treatment. Feasibility of the study was defined by at least 55% of patients receiving all scheduled APNLC-led consultations and completing PROMs assessments at the three timepoints.

RESULTS

In total, 35/46 (76%) (95% CI, 0.61 to 0.87) of patients met the feasibility criteria receiving all scheduled APNLC consultations. Fifty-six percent (26/46) (95% CI, 0.41 to 0.71) completed the PROMs at the three timepoints. Self-efficacy for managing symptoms remained stable, intensity of predominant symptoms increased. Unmet information needs decreased significantly while psychological and sexuality related needs increased over time.

CONCLUSION

Results were promising for the feasibility of the APNLC consultation and the ability to collect PROMs. Further investigations are needed to increase the impact of the APNLC consultations on symptom intensity and sexual and psychological needs.

摘要

目的

关于高级执业护士在肺癌治疗中的有效性的数据有限。先前的研究表明,调查存在障碍,包括肺癌患者招募率低和失访率高。本研究的主要目的是评估高级执业护士咨询的可行性以及在一线治疗期间收集患者报告结局指标(PROMs)的能力。次要目的是描述一线治疗期间高级执业护士所诊治患者在管理肺癌相关症状的自我效能、症状强度/负担以及未满足的支持性护理需求方面的变化。

方法

采用精确的单阶段II期设计。我们在瑞士一家肿瘤门诊中心连续招募了新诊断为肺癌并接受全身治疗的患者样本。干预措施包括在一线治疗期间进行四次系统的、交替的面对面/电话咨询。该研究的可行性定义为至少55%的患者接受所有预定的由高级执业护士主导的咨询,并在三个时间点完成PROMs评估。

结果

总共35/46(76%)(95%置信区间,0.61至0.87)的患者符合接受所有预定的高级执业护士咨询的可行性标准。56%(26/46)(95%置信区间,0.41至0.71)的患者在三个时间点完成了PROMs评估。管理症状的自我效能保持稳定,主要症状的强度增加。未满足的信息需求显著减少,而心理和性相关需求随时间增加。

结论

高级执业护士咨询的可行性以及收集PROMs的能力方面的结果很有前景。需要进一步研究以增强高级执业护士咨询对症状强度以及性和心理需求的影响。

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