Center of Community Alliance for Research and Education (CCARE), Division of Health Equities, City of Hope Medical Center, 1500 East Duarte Road, Duarte, CA, 91010-3000, USA.
Breast Cancer Program, Oncology Department, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Support Care Cancer. 2020 Mar;28(3):1163-1171. doi: 10.1007/s00520-019-04899-7. Epub 2019 Jun 15.
African American breast cancer survivors (AABCS) are underserved in medical and psychosocial care despite greater disease burden. We evaluated the effectiveness of a telephonic psycho-educational intervention trial on improving emotional well-being (EWB) in a sample of AABCS.
Secondary data analyses with 40 AABCS who reported elevated distress were randomly assigned to the intervention or control group. We used Wilcoxon signed rank tests to measure pre- to post-intervention score changes in individual EWB items (FACT-G). Independent t tests compared changes in mean scores between the intervention and control groups.
Overall emotional well-being, as well as emotions pertaining to sadness, coping, and nervousness, showed some improvements as a result of the intervention. Changes in the subscale total score and all except one subscale item had clinically meaningful effect sizes (d ≥ 0.35). Statistically significant between-group differences in mean score changes were observed.
Our results and approach advance supportive care interventions by illuminating the benefits and limitations of a paraprofessional delivered, licensed professional supervised psycho-educational intervention. Additionally, as emotional well-being is multifaceted, the individual item analysis approach used in this study provides insight into specific areas of improvement and vulnerability within the emotional well-being domain of health-related quality of life (HRQOL). Our findings can facilitate the development of culturally responsive and patient-centered survivorship care, psychosocial-oncology interventions and care-tailored to the emotional well-being and unmet needs of medically vulnerable and underserved patients.
尽管非裔美国乳腺癌幸存者(AABCS)面临更大的疾病负担,但他们在医疗和心理社会护理方面的服务不足。我们评估了一项电话心理教育干预试验在改善一组 AABCS 的情绪健康(EWB)方面的有效性。
对报告有较高压力的 40 名 AABCS 进行二次数据分析,将他们随机分配到干预组或对照组。我们使用 Wilcoxon 符号秩检验来衡量个体 EWB 项目(FACT-G)的干预前后评分变化。独立 t 检验比较了干预组和对照组之间平均评分变化的差异。
整体情绪健康以及与悲伤、应对和紧张有关的情绪都因干预而有所改善。子量表总分和除一个子量表项目外的所有项目的变化均具有临床意义的效应大小(d≥0.35)。观察到组间平均评分变化的统计学显著差异。
我们的结果和方法通过阐明准专业人员提供、持牌专业人员监督的心理教育干预的益处和局限性,推进了支持性护理干预。此外,由于情绪健康是多方面的,本研究中使用的个体项目分析方法提供了对健康相关生活质量(HRQOL)的情绪健康领域内特定改善和脆弱领域的深入了解。我们的研究结果可以促进针对情绪健康和医疗脆弱和服务不足患者的未满足需求的文化响应和以患者为中心的生存护理、心理肿瘤学干预和护理的发展。