van Beusekom Mara, Cameron Josie, Bedi Carolyn, Banks Elspeth, Kelsey Tom, Humphris Gerry
1School of Medicine, University of St Andrews, St Andrews, UK.
2Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK.
Pilot Feasibility Stud. 2018 Sep 18;4:148. doi: 10.1186/s40814-018-0338-9. eCollection 2018.
Many patients who have been treated for breast cancer experience high levels of fear that the cancer will return. The FORECAST pilot study showed that for a third of the patients, fears of cancer recurrence (FCR) increase during radiotherapy treatment and that conversations with their therapeutic radiographer at the weekly review meetings might help patients manage these concerns. This study aims to develop a communication skills training package (KEW, for 'Know', 'Encourage' and 'Warm-up') for therapeutic radiographers based on the findings of the FORECAST pilot study and on active input from patients and radiographers. This package will be piloted in a single centre to evaluate its acceptability and to prepare for a multi-centre clinical trial.
The study consists of three phases. In the first phase, patient representatives and therapeutic radiographers participate in Experience-Based Co-Design to identify ways to improve communication during the radiotherapy review. In the second phase, various stakeholders, including members of the Society of Radiographers and of national patient representation groups, are consulted to develop a storyboard for the production of the communication training package. In the third phase, the acceptability and feasibility of the training is evaluated through observations, recruitment rates and follow-up discussions; a fidelity measure is designed; and potential benefits are observed, with patients' fear of cancer recurrence (FCR7) as the primary outcome. Secondary outcomes include a short daily measure of recurrence (FCR3), patients' positive and negative affect (PANAS), perceived empathy from the radiographer (CARE), satisfaction with the review meetings (RISS) and health-related quality of life (EQ-5D-3L).
To date, there has been limited research on how communication between therapeutic radiographers and patients during review appointments can help to manage patients' recurrence fears during radiotherapy treatment. A collaborative and participatory approach to the development of a communication skills training will ensure that it is optimally targeted to the needs and preferences of both patients and radiographers. Targeting recurrence fears through communication at this stage, when patients are still in regular contact with healthcare providers, has the potential to reduce the need for complex interventions post-treatment.
NRES reference: 18/LO/0669. Clinicaltrial.gov ID: NCT03468881.
许多接受过乳腺癌治疗的患者极度担心癌症会复发。“预测”试点研究表明，三分之一的患者在放疗期间对癌症复发的恐惧（FCR）会增加，并且在每周的复查会议上与放射治疗技师交谈可能有助于患者应对这些担忧。本研究旨在根据“预测”试点研究的结果以及患者和放射治疗技师的积极反馈，为放射治疗技师开发一套沟通技能培训方案（KEW，代表“了解”“鼓励”和“热身”）。该方案将在单一中心进行试点，以评估其可接受性，并为多中心临床试验做准备。
该研究包括三个阶段。在第一阶段，患者代表和放射治疗技师参与基于经验的协同设计，以确定改善放疗复查期间沟通的方法。在第二阶段，咨询包括放射技师协会成员和全国患者代表团体成员在内的各种利益相关者，以制定沟通培训方案制作的脚本。在第三阶段，通过观察、招募率和后续讨论来评估培训的可接受性和可行性；设计一项保真度测量；观察潜在益处，以患者对癌症复发的恐惧（FCR7）作为主要结果。次要结果包括每日简短的复发测量（FCR3）、患者的积极和消极情绪（PANAS）、对放射治疗技师的感知同理心（CARE）、对复查会议的满意度（RISS）以及健康相关生活质量（EQ - 5D - 3L）。
迄今为止，关于放射治疗技师与患者在复查预约期间的沟通如何有助于应对患者放疗期间对复发的恐惧的研究有限。采用协作和参与式方法来开发沟通技能培训将确保其最佳地满足患者和放射治疗技师的需求与偏好。在患者仍与医疗保健提供者保持定期联系的这个阶段，通过沟通来应对复发恐惧有可能减少治疗后进行复杂干预的需求。
NRES编号：18/LO/0669。Clinicaltrial.gov标识符：NCT03468881。
