International Observatory on End of Life Care, Division of Health Research, Lancaster University, Bailrigg, Lancaster, UK.
Division of Nursing, Midwifery and Social Work, Manchester University, Manchester, UK.
BMC Palliat Care. 2020 Aug 17;19(1):129. doi: 10.1186/s12904-020-00631-z.
Advanced cancer affects people's lives, often causing stress, anxiety and depression. Peer mentor interventions are used to address psychosocial concerns, but their outcomes and effect are not known. Our objective was to determine the feasibility of delivering and investigating a novel peer mentor intervention to promote and maintain psychological wellbeing in people with advanced cancer.
A mixed methods design incorporating a two-armed controlled trial (random allocation ratio 1:1) of a proactive peer mentor intervention plus usual care, vs. usual care alone, and a qualitative process evaluation. Peer mentors were recruited, trained, and matched with people with advanced cancer. Quantitative data assessed quality of life, coping styles, depression, social support and use of healthcare and other supports. Qualitative interviews probed experiences of the study and intervention.
Peer mentor training and numbers (n = 12) met feasibility targets. Patient participants (n = 12, from 181 eligible who received an information pack) were not recruited to feasibility targets. Those who entered the study demonstrated that intervention delivery and data collection were feasible. Outcome data must be treated with extreme caution due to small numbers, but indicate that the intervention may have a positive effect on quality of life.
Peer mentor interventions are worthy of further study and researchers can learn from these feasibility data in planning participant recruitment and data collection strategies. Pragmatic trials, where the effectiveness of an intervention is tested in real-world routine practice, may be most appropriate. Peer mentor interventions may have merit in enabling survivors with advanced cancer cope with their disease.
The trial was prospectively registered 13.6.2016: ISRCTN10276684 .
晚期癌症影响人们的生活,常导致压力、焦虑和抑郁。同伴导师干预用于解决心理社会问题,但它们的结果和效果尚不清楚。我们的目的是确定提供和研究一种新的同伴导师干预措施的可行性,以促进和维持晚期癌症患者的心理健康。
采用混合方法设计,包括一项前瞻性同伴导师干预加常规护理与单独常规护理的两臂对照试验(随机分配比为 1:1),以及一项定性过程评估。招募、培训和匹配同伴导师与晚期癌症患者。定量数据评估生活质量、应对方式、抑郁、社会支持以及医疗保健和其他支持的使用情况。定性访谈探讨了研究和干预的经验。
同伴导师培训和人数(n=12)达到了可行性目标。符合条件的 181 名患者中只有 12 名(n=12)收到了信息包,没有招募到可行性目标的患者。进入研究的患者表明干预的实施和数据收集是可行的。由于患者数量较少,必须谨慎对待研究结果,但数据表明该干预措施可能对生活质量有积极影响。
同伴导师干预值得进一步研究,研究人员可以从这些可行性数据中学习,为计划患者招募和数据收集策略提供参考。在现实世界的常规实践中测试干预效果的实用试验可能最适合。同伴导师干预可能对帮助晚期癌症幸存者应对疾病有一定价值。
该试验于 2016 年 6 月 13 日前瞻性注册:ISRCTN84103004。