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家庭健康对话是否会影响胶质母细胞瘤多形性患者及其家庭成员?

Do family health conversations impact patients with glioblastoma multiforme and their family members?

机构信息

Department of Neurosurgery, Odense University Hospital, Odense C, Denmark.

Department of Business and Economics, Centre of Health Economics Research (COHERE), University of Southern Denmark, Odense M, Denmark.

出版信息

J Clin Nurs. 2019 May;28(9-10):1695-1707. doi: 10.1111/jocn.14777. Epub 2019 Jan 29.

Abstract

AIMS AND OBJECTIVES

To assess the impact of family health conversations (FamHC) as a supplement to conventional care on health-related quality of life (HRQoL), family functioning (FFSS) and family hardiness or resilience (FHI) 4 and 14 weeks postoperatively among patients with glioblastoma multiforme and their family members.

BACKGROUND

There is a lack of knowledge about the efficiency of FamHC among families experiencing glioblastoma multiforme.

DESIGN

A quasi-experimental pre- and post-test design adhering to the STROBE (Strengthening the reporting of observational studies in epidemiology) guidelines for case-control studies. Patients and family members were included consecutively in the pretest period from November 2013-December 2014 for the control group (offered traditional care only), and in the post-test period from January 2015-December 2015 for the intervention group (offered traditional care and FamHC). For both groups, 4 and 14 weeks postoperative measurement were obtained.

METHODS

Differences in outcomes were assessed using a difference-in-difference regression analysis approach measuring difference across pre and post groups and across 4 and 14 weeks measurements.

RESULTS

The study does not reveal significant effects of FamHC (all p-values larger than 0.05) as measured by the three instruments WHOQOL-BREF, FFSS and FHI.

CONCLUSIONS

The present study was not able to show significant effects of FamHC. However, it cannot be left out that the intervention might be helpful and supportive at a later state of the illness trajectory.

RELEVANCE FOR CLINICAL PRACTICE

The study adds to the growing evidence-based knowledge on FamHC by questioning their potential use in different cultural contexts among families experiencing critical illness. Oncological nurses need to adapt this information to support their daily care for the patients and their close relatives. For future studies, it is recommended that the families themselves choose when the conversations should take place during the course of the illness.

摘要

目的和目标

评估家庭健康对话(FamHC)作为常规护理的补充,对胶质母细胞瘤患者及其家属的健康相关生活质量(HRQoL)、家庭功能(FFSS)和家庭坚韧度或适应力(FHI)的影响,分别在术后 4 周和 14 周进行评估。

背景

对于经历胶质母细胞瘤的家庭来说,FamHC 的效率知之甚少。

设计

采用准实验前后测试设计,遵循 STROBE(加强观察性研究在流行病学中的报告)指南进行病例对照研究。患者及其家属在预测试期内(2013 年 11 月至 2014 年 12 月)连续纳入对照组(仅接受传统护理),在测试期内(2015 年 1 月至 2015 年 12 月)纳入干预组(接受传统护理和 FamHC)。两组均在术后 4 周和 14 周进行测量。

方法

采用差异-差异回归分析方法评估结果差异,测量预组和后组之间以及 4 周和 14 周测量之间的差异。

结果

本研究未发现 FamHC 的显著效果(所有 p 值均大于 0.05),以 WHOQOL-BREF、FFSS 和 FHI 三种工具测量。

结论

本研究未能显示 FamHC 的显著效果。然而,不能排除干预在疾病轨迹的后期可能会有所帮助和支持。

临床实践相关性

该研究通过质疑 FamHC 在经历危重病的家庭中在不同文化背景下的潜在用途,为 FamHC 的循证知识的增长做出了贡献。肿瘤护士需要适应这些信息,以支持他们对患者及其近亲的日常护理。对于未来的研究,建议让家庭自己选择在疾病过程中何时进行对话。

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