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一项帮助患者管理雄激素剥夺疗法副作用的教育项目:可行性、可接受性及初步结果

An Educational Program to Help Patients Manage Androgen Deprivation Therapy Side Effects: Feasibility, Acceptability, and Preliminary Outcomes.

作者信息

Wibowo Erik, Wassersug Richard J, Robinson John W, Santos-Iglesias Pablo, Matthew Andrew, McLeod Deborah L, Walker Lauren M

机构信息

University of Otago, Dunedin, New Zealand.

University of British Columbia, Vancouver, Canada.

出版信息

Am J Mens Health. 2020 Jan-Feb;14(1):1557988319898991. doi: 10.1177/1557988319898991.

Abstract

Androgen deprivation therapy (ADT), a common treatment for prostate cancer, is associated with physical, psychological, and sexual side effects that reduce patients' quality of life. The authors designed an educational program to prepare patients for managing these side effects. This paper describes an implementation model for national dissemination of the program, testing its feasibility and acceptability at the institutional and patient level. Postprogram changes in patients' self-efficacy to manage side effects and side effect bother are also explored. Patients on or anticipating ADT enrolled in the educational program. Pre and post intervention questionnaires measured patient satisfaction with the program, side effect bother, and self-efficacy to manage ADT side effects. The ADT Educational Program was deemed feasible and acceptable. Five of six targeted sites successfully launched the program with sufficient patient enrolment. Patient attendees were highly satisfied. Self-efficacy, bother, and use of management strategies were interrelated. Lower bother was associated with increased self-efficacy and more use of management strategies, and increased bother was associated with lower self-efficacy and less use of management strategies. Based on pre-post scores, improvements in patients' self-efficacy to manage ADT side effects were also observed. Results demonstrate that this brief educational program is feasible and acceptable to patients and cancer care institutions. The program appears to promote self-efficacy and the uptake of ADT management strategies for ADT side effects. The results of this study support the program implementation and suggest that improvements in self-efficacy after program participation may help patients adapt to ADT side effects.

摘要

雄激素剥夺疗法(ADT)是前列腺癌的一种常见治疗方法,它会带来身体、心理和性方面的副作用,降低患者的生活质量。作者设计了一个教育项目,帮助患者应对这些副作用。本文描述了该项目在全国范围内推广的实施模式,在机构和患者层面测试其可行性和可接受性。同时还探讨了项目实施后患者应对副作用的自我效能感以及副作用困扰程度的变化。正在接受或即将接受ADT治疗的患者参加了该教育项目。干预前后的问卷调查测量了患者对项目的满意度、副作用困扰程度以及应对ADT副作用的自我效能感。ADT教育项目被认为是可行且可接受的。六个目标地点中有五个成功启动了该项目,并有足够的患者参与。参与项目的患者满意度很高。自我效能感、困扰程度和管理策略的使用是相互关联的。较低的困扰程度与自我效能感的提高和更多地使用管理策略相关,而较高的困扰程度则与自我效能感的降低和较少地使用管理策略相关。根据前后得分,还观察到患者应对ADT副作用的自我效能感有所提高。结果表明,这个简短的教育项目对患者和癌症护理机构来说是可行且可接受的。该项目似乎能提高自我效能感,并促进患者采用ADT副作用管理策略。本研究结果支持该项目的实施,并表明项目参与后自我效能感的提高可能有助于患者适应ADT副作用。

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