Tong Eryn, Lo Chris, Moura Shari, Antes Kelly, Buchanan Sarah, Kamtapersaud Venissa, Devins Gerald M, Zimmermann Camilla, Gallinger Steven, Rodin Gary
1Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 700 Bay St., Suite 2303, Toronto, Ontario M5G 1Z6 Canada.
2Institute of Medical Science, University of Toronto, Toronto, Canada.
Pilot Feasibility Stud. 2019 Jun 20;5:80. doi: 10.1186/s40814-019-0466-x. eCollection 2019.
Pancreatic cancer has one of the highest mortality rates of any malignancy, placing a substantial burden on patients and families with high unmet informational and supportive care needs. Nevertheless, access to psychosocial and palliative care services for the individuals affected is limited. There is a need for standardized approaches to facilitate adjustment and to improve knowledge about the disease and its anticipated impact. In this intervention-development paper guided by implementation science principles, we report the rationale, methods, and processes employed in developing an interdisciplinary group psychoeducational intervention for people affected by pancreatic cancer. The acceptability and feasibility of implementation will be evaluated as a part of a subsequent feasibility study.
The Schofield and Chambers framework for designing sustainable self-management interventions in cancer care informed the development of the intervention content and format. The Consolidated Framework for Implementation Research served as an overarching guide of the implementation process, including the development phase and the formative evaluation plan of implementation.
A representative team of stakeholders collaboratively developed and tailored the intervention content and format with attention to the principles of implementation science, including available resourcing. The final intervention prototype was designed as a single group-session led by an interdisciplinary clinical team with expertise in caring for patients with pancreatic cancer and their families and in addressing nutrition guidelines, disease and symptom management, communication with family and health care providers, family impact of cancer, preparing for the future, and palliative and supportive care services.
The present paper describes the development of a group psychoeducational intervention to address the informational and supportive care needs of people affected by pancreatic cancer. Consideration of implementation science during intervention development efforts can optimize uptake and sustainability in the clinical setting. Our approach may be utilized as a framework for the design and implementation of similar initiatives to support people affected by diseases with limited prognoses.
胰腺癌是所有恶性肿瘤中死亡率最高的疾病之一,给患者及其家庭带来了沉重负担,他们有大量未得到满足的信息需求和支持性护理需求。然而,受影响个体获得心理社会和姑息治疗服务的机会有限。需要采用标准化方法来促进适应并提高对该疾病及其预期影响的认识。在这篇以实施科学原则为指导的干预开发论文中,我们报告了为胰腺癌患者开发跨学科团体心理教育干预所采用的基本原理、方法和过程。作为后续可行性研究的一部分,将评估实施的可接受性和可行性。
Schofield和Chambers在癌症护理中设计可持续自我管理干预的框架为干预内容和形式的开发提供了指导。实施研究综合框架作为实施过程的总体指南,包括开发阶段和实施的形成性评估计划。
一个具有代表性的利益相关者团队共同开发并调整了干预内容和形式,同时关注实施科学的原则,包括可用资源。最终的干预原型设计为一次由跨学科临床团队主导的团体会议,该团队在照顾胰腺癌患者及其家属、遵循营养指南、疾病和症状管理、与家人及医疗服务提供者沟通、癌症对家庭的影响、为未来做准备以及姑息和支持性护理服务等方面具有专业知识。
本文描述了一种团体心理教育干预的开发,以满足胰腺癌患者的信息需求和支持性护理需求。在干预开发过程中考虑实施科学可以优化临床环境中的接受度和可持续性。我们的方法可作为设计和实施类似举措的框架,以支持受预后有限疾病影响的人群。