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开发和试点测试针对医疗服务不足社区的移动医疗行为癌痛方案。

Development and pilot testing of an mHealth behavioral cancer pain protocol for medically underserved communities.

机构信息

a Duke University Medical Center , Durham , North Carolina , USA.

b University of Alabama , Tuscaloosa , Alabama , USA.

出版信息

J Psychosoc Oncol. 2019 May-Jun;37(3):335-349. doi: 10.1080/07347332.2018.1479327. Epub 2018 Dec 26.

Abstract

The purpose of this study was to refine and test a mobile-health behavioral cancer pain coping skills training protocol for women with breast cancer and pain from medically underserved areas. Three focus groups (Phase 1) were used to refine the initial protocol. A single-arm pilot trial (Phase 2) was conducted to assess feasibility, acceptability, and changes in outcomes. The intervention was delivered at a community-based clinic via videoconferencing technology. Participants were women (N = 19 for Phase 1 and N = 20 for Phase 2) with breast cancer and pain in medically underserved areas. Major themes from focus groups were used to refine the intervention. The refined intervention demonstrated feasibility and acceptability. Participants reported significant improvement in pain severity, pain interference, and self-efficacy for pain management. Our intervention is feasible, acceptable, and likely to lead to improvement in pain-related outcomes for breast cancer patients in medically underserved areas. Implications for Psychosocial Oncology Practice Breast cancer patients being treated in medically underserved areas have a dearth of exposure to behavioral interventions that may improve their ability to manage pain. Evidence from this single-arm pilot trial suggests that our mobile-health behavioral cancer pain coping skills training protocol is acceptable and feasible in this vulnerable population. Appropriately adapted mobile-health technologies may provide an avenue to reach underserved patients and implement behavioral interventions to improve pain management.

摘要

本研究旨在完善并测试针对医疗服务不足地区乳腺癌伴疼痛女性的移动医疗行为癌症疼痛应对技能培训方案。采用三个焦点小组(第 1 阶段)对初始方案进行了完善。开展了一项单臂试验性试验(第 2 阶段)以评估其可行性、可接受性和结果变化。干预措施通过视频会议技术在社区诊所实施。参与者为患有乳腺癌且处于医疗服务不足地区伴有疼痛的女性(第 1 阶段有 19 名参与者,第 2 阶段有 20 名参与者)。焦点小组的主要主题被用于完善干预措施。经完善的干预措施显示出可行性和可接受性。参与者报告称疼痛严重程度、疼痛干扰和疼痛管理自我效能感显著改善。我们的干预措施是可行的、可接受的,并且可能会改善医疗服务不足地区乳腺癌患者的疼痛相关结局。心理肿瘤学实践的意义 在医疗服务不足地区接受治疗的乳腺癌患者很少接触可能提高其疼痛管理能力的行为干预措施。来自这项单臂试验性试验的证据表明,我们的移动医疗行为癌症疼痛应对技能培训方案在这一弱势群体中是可接受和可行的。适当调整的移动医疗技术可能为接触服务不足的患者并实施改善疼痛管理的行为干预措施提供了一种途径。

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