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护士和同伴主导的心理教育干预以支持接受根治性放疗的妇科癌症女性:PeNTAGOn 随机对照试验 - ANZGOG 1102。

A nurse- and peer-led psycho-educational intervention to support women with gynaecological cancers receiving curative radiotherapy: The PeNTAGOn randomised controlled trial - ANZGOG 1102.

机构信息

Behavioural Sciences Unit, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, VIC 3000, Australia; Department of Psychological Science, Iverson Health Innovation Research Institute Swinburne University of Technology, John St, Hawthorn, VIC 3122, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC 3010, Australia.

Cancer Care Delivery Research, Department of Cancer Experiences, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, VIC 3000, Australia.

出版信息

Gynecol Oncol. 2020 Dec;159(3):785-793. doi: 10.1016/j.ygyno.2020.09.016. Epub 2020 Sep 19.

Abstract

OBJECTIVE

Radiotherapy for gynaecological cancer is associated with multiple adverse effects. This randomised controlled trial evaluated the impact of a combined nurse- and peer-led psycho-educational intervention on psychological distress, preparation for treatment, quality of life, psychosexual function, unmet needs and vaginal stenosis.

METHODS

Eligible women had a confirmed diagnosis of gynaecological cancer, scheduled to receive radiotherapy with curative intent, aged ≥18 years, and able to read and write English. Participants randomly assigned one-to-one to either four nurse-led consultations plus four peer-led telephone sessions, or to usual care. Participants completed study measures at baseline, immediately before first radiotherapy (FU1), and four weeks (FU2), three (FU3), six (FU4), and 12 months (FU5) post radiotherapy. The primary outcomes were psychological distress at FU1 and FU2 measured by the Hospital Anxiety and Depression Scale.

RESULTS

Of 840 eligible participants, 625 were approached and 319 (51%) consented; 158 assigned to intervention, 160 to usual care with 1 withdrawing before randomisation. Between-groups differences for primary outcomes were trivial- and small-sized, (both p > 0.05). Notable effects on secondary outcomes favouring the intervention at FU2 included preparation for treatment (sensory/psychological concerns, d = 0.57; and procedural concerns, d = 0.52) and specific needs domains (sexuality needs, d = 0.38; and health system and information needs, d = 0.41).

CONCLUSIONS

There was no evidence that a nurse- and peer-led intervention had a beneficial effect on psychological distress compared to usual care. However, improved treatment readiness and lower health system and sexuality needs indicate the intervention may have addressed outcomes known to be important to this population.

摘要

目的

妇科癌症的放射治疗会引起多种不良反应。本随机对照试验评估了由护士和同伴联合主导的心理教育干预对心理困扰、治疗准备、生活质量、性心理功能、未满足的需求和阴道狭窄的影响。

方法

符合条件的女性患有明确的妇科癌症诊断,计划接受根治性放疗,年龄≥18 岁,能够读写英语。参与者以一对一的方式随机分配到四个护士主导的咨询加四个同伴主导的电话会议组,或常规护理组。参与者在基线、第一次放疗前(FU1)和四周(FU2)、三个月(FU3)、六个月(FU4)和 12 个月(FU5)后完成研究测量。主要结局是在 FU1 和 FU2 通过医院焦虑和抑郁量表测量的心理困扰。

结果

在 840 名符合条件的参与者中,有 625 人被接触,有 319 人(51%)同意;158 人被分配到干预组,160 人被分配到常规护理组,其中 1 人在随机分组前退出。主要结局的组间差异微不足道且较小(均 p>0.05)。在 FU2 时,干预对次要结局有显著影响,包括治疗准备(感觉/心理问题,d=0.57;程序问题,d=0.52)和特定需求领域(性需求,d=0.38;卫生系统和信息需求,d=0.41)。

结论

与常规护理相比,护士和同伴主导的干预在心理困扰方面没有证据表明有有益的效果。然而,治疗准备的改善和较低的卫生系统和性需求表明,该干预可能解决了对这一人群很重要的结果。

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