Beckman Research Institute of the City of Hope, Division of Nursing Research and Education, Department of Population Sciences, Duarte, CA, USA.
Beckman Research Institute of the City of Hope, Division of Nursing Research and Education, Department of Population Sciences, Duarte, CA, USA.
Eur J Oncol Nurs. 2020 Dec;49:101855. doi: 10.1016/j.ejon.2020.101855. Epub 2020 Oct 7.
To assess the feasibility, acceptability, and preliminary effects of a nurse-led intervention for managing fear of cancer progression in advanced cancer patients.
A single group mixed methods study was conducted in patients with stage III or IV gynecologic or lung cancer (n = 31) with dysfunctional levels of fear of progression or distress. The intervention consisted of seven videoconferencing sessions with skills practice. Feasibility measures included enrollment rate, attendance, attrition, and home practice adherence. Acceptability was based on exit interview responses. Content analysis was used to analyze the qualitative data. Participants completed quantitative questionnaires assessing fear of progression and secondary outcomes at baseline, eight, and 12 weeks. Linear mixed model analysis was used to assess changes in outcome measures.
The average enrollment rate was seven participants/month over 4.5 months. Participants attended a mean of 5.3 of seven sessions. Attrition rate was 30%. The analysis showed improvements over time in fear of progression and exploratory outcomes. Participants reported feeling calmer and more focused. The skills practice helped to manage anxiety and fears. Themes included: Struggling with fears, Refocusing the fears, and Realizing/reaffirming what is important in life. The most beneficial components included the values clarification exercise, detached mindfulness and worry postponement practices.
The intervention was acceptable; most feasibility criteria were met. Preliminary data suggest that the intervention reduced fear of progression and improved secondary outcomes. The intervention required a significant time commitment by participants, which may have contributed to increased attrition. To decrease burden, we will shorten the intervention.
评估护士主导的干预措施管理晚期癌症患者对癌症进展恐惧的可行性、可接受性和初步效果。
对患有 III 期或 IV 期妇科或肺癌的患者（n=31）进行了一项单组混合方法研究，这些患者存在功能失调的进展恐惧或痛苦程度。该干预措施包括七次视频会议和技能实践。可行性措施包括入组率、出席率、流失率和家庭实践的坚持率。可接受性基于退出访谈的回复。内容分析用于分析定性数据。参与者在基线、8 周和 12 周时完成了评估进展恐惧和次要结果的定量问卷。线性混合模型分析用于评估结果测量的变化。
平均每月有 7 名参与者入组，历时 4.5 个月。参与者平均参加了 7 次课程中的 5.3 次。流失率为 30%。分析显示，随着时间的推移，对进展的恐惧和探索性结果有所改善。参与者报告感到更加平静和专注。技能实践有助于管理焦虑和恐惧。主题包括：恐惧的挣扎、重新聚焦恐惧、以及意识到/重新确认生活中重要的事情。最有益的组成部分包括价值观澄清练习、超脱的正念和推迟担忧的练习。
该干预措施是可接受的；大多数可行性标准都得到了满足。初步数据表明，该干预措施降低了对进展的恐惧，并改善了次要结果。该干预措施需要参与者投入大量时间，这可能导致流失率增加。为了减少负担，我们将缩短干预措施的时间。
