对有再次发生黑色素瘤高风险人群的心理教育干预：一项试点随机对照试验。
Psychoeducational intervention for people at high risk of developing another melanoma: a pilot randomised controlled trial.
作者信息
Dieng Mbathio, Kasparian N A, Mireskandari Shab, Butow Phyllis, Costa Daniel, Morton Rachael, Mann Graham, Menzies Scott, Cust Anne
机构信息
Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia.
出版信息
BMJ Open. 2017 Oct 10;7(10):e015195. doi: 10.1136/bmjopen-2016-015195.
INTRODUCTION
Information and psychological needs have been reported as one of the greatest areas of unmet needs for patients with melanoma. To respond to these needs, we developed the a developed psychoeducational intervention for people at high risk of developing another melanoma comprising of a newly developed melanoma educational booklet and individually tailored telephone support sessions provided by trained psychologists. The purpose of this study was to investigate the acceptability and feasibility of the .
METHODS
Twenty-four adults (14 men, 10 women, mean age: 58 years, SD: 12.2) at high risk of developing a subsequent primary melanoma were recruited and randomly assigned 1:1 to the intervention (a psychoeducational booklet, a Cancer Council booklet on melanoma and up to five telephone-based sessions with a psychologist) or usual care (Cancer Council booklet only). Acceptability, feasibility, fear of cancer recurrence and secondary psychosocial outcomes were assessed at baseline, 1 and 6 months.
RESULTS
Satisfaction and perceived benefits were rated highly for all intervention components, particularly the telephone-based psychology sessions (mean satisfaction and benefits: both 9.27 out of 10, SD=2.41). The quality of information and support provided throughout the trial was rated as 'high' by the intervention group, with a mean score of 4.6 out of a possible 5 (SD=0.9) and 4.2 (SD=1.2) for the control group.
CONCLUSIONS
The intervention was feasible and acceptable for improving psychological adjustment. Timely access to effective, evidence-based, psychological care is a recognised need for people with melanoma. The intervention is designed to directly address this need in a way that is feasible in a clinical setting, acceptable to patients and health professionals.
TRIAL REGISTRATION NUMBER
The trial was registered with the Australian and New Zealand Clinical Trials Registry on 19/03/2013 (Registration Number: ACTRN12613000304730).
引言
信息和心理需求被认为是黑色素瘤患者未得到满足的最大需求领域之一。为满足这些需求，我们为有再次患黑色素瘤高风险的人群开发了一种心理教育干预措施，包括一本新编写的黑色素瘤教育手册以及由训练有素的心理学家提供的个性化电话支持课程。本研究的目的是调查该干预措施的可接受性和可行性。
方法
招募了24名有再次患原发性黑色素瘤高风险的成年人（14名男性，10名女性，平均年龄：58岁，标准差：12.2），并将他们以1:1的比例随机分配到干预组（一本心理教育手册、一本癌症理事会的黑色素瘤手册以及最多五次与心理学家的电话课程）或常规护理组（仅癌症理事会手册）。在基线、1个月和6个月时评估可接受性、可行性、对癌症复发的恐惧以及继发性心理社会结果。
结果
所有干预组件的满意度和感知益处评分都很高，尤其是基于电话的心理课程（平均满意度和益处：均为10分中的9.27分，标准差 = 2.41）。干预组对整个试验期间提供的信息和支持质量评为“高”，平均得分为可能的5分中的4.6分（标准差 = 0.9），对照组为4.2分（标准差 = 1.2）。
结论
该干预措施对于改善心理调适是可行且可接受的。黑色素瘤患者公认需要及时获得有效、基于证据的心理护理。该干预措施旨在以一种在临床环境中可行、患者和健康专业人员都能接受的方式直接满足这一需求。
试验注册号
该试验于2013年3月19日在澳大利亚和新西兰临床试验注册中心注册（注册号：ACTRN12613000304730）。
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