Watson Eila K, Shinkins Bethany, Matheson Lauren, Burns Richeal M, Frith Emma, Neal David, Hamdy Freddie, Walter Fiona M, Weller David, Wilkinson Claire, Faithfull Sara, Sooriakumaran Prasanna, Kastner Christof, Campbell Christine, Neal Richard D, Butcher Hugh, Matthews Mike, Perera Rafael, Wolstenholme Jane, Rose Peter W
Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, OX3 OFL, UK.
Department of Primary Health Care Sciences, University of Oxford, New Radcliffe House, 2nd Floor, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
Eur J Oncol Nurs. 2018 Feb;32:73-81. doi: 10.1016/j.ejon.2017.12.002. Epub 2017 Dec 29.
This study sought to test the acceptability and feasibility of a nurse-led psycho-educational intervention (NLPI) delivered in primary care to prostate cancer survivors, and to provide preliminary estimates of the effectiveness of the intervention.
Men who reported an ongoing problem with urinary, bowel, sexual or hormone-related functioning/vitality on a self-completion questionnaire were invited to participate. Participants were randomly assigned to the NLPI plus usual care, or to usual care alone. Recruitment and retention rates were assessed. Prostate-related quality of life, self-efficacy, unmet needs, and psychological morbidity were measured at baseline and 9 months. Health-care resource use data was also collected. An integrated qualitative study assessed experiences of the intervention.
61% eligible men (83/136) participated in the trial, with an 87% (72/83) completion rate. Interviews indicated that the intervention filled an important gap in care following treatment completion, helping men to self-manage, and improving their sense of well-being. However, only a small reduction in unmet needs and small improvement in self-efficacy was observed, and no difference in prostate-related quality of life or psychological morbidity. Patients receiving the NLPI recorded more primary care visits, while the usual care group recorded more secondary care visits. Most men (70%; (21/30)) felt the optimal time for the intervention was around the time of diagnosis/before the end of treatment.
Findings suggest a nurse-led psycho-educational intervention in primary care is feasible, acceptable and potentially useful to prostate cancer survivors.
本研究旨在测试在初级保健中为前列腺癌幸存者提供的由护士主导的心理教育干预（NLPI）的可接受性和可行性，并对该干预的有效性进行初步评估。
邀请那些在自我完成问卷中报告存在泌尿、肠道、性或激素相关功能/活力持续问题的男性参与。参与者被随机分配到NLPI加常规护理组，或仅接受常规护理组。评估招募率和保留率。在基线和9个月时测量前列腺相关生活质量、自我效能感、未满足的需求和心理发病率。还收集了医疗保健资源使用数据。一项综合定性研究评估了干预的体验。
61%符合条件的男性（83/136）参与了试验，完成率为87%（72/83）。访谈表明，该干预填补了治疗完成后护理方面的重要空白，帮助男性进行自我管理，并改善了他们的幸福感。然而，仅观察到未满足需求有小幅减少，自我效能感有小幅改善，前列腺相关生活质量或心理发病率没有差异。接受NLPI的患者记录的初级保健就诊次数更多，而常规护理组记录的二级保健就诊次数更多。大多数男性（70%；（21/30））认为干预的最佳时间是在诊断时/治疗结束前。
研究结果表明，在初级保健中由护士主导的心理教育干预对前列腺癌幸存者是可行的、可接受的且可能有用的。
