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针对拉丁裔癌症幸存者及其照料者的生活方式干预:Nuestra Salud随机试点试验

Lifestyle intervention for Latina cancer survivors and caregivers: the Nuestra Salud randomized pilot trial.

作者信息

Crane Tracy E, Badger Terry A, O'Connor Patrick, Segrin Chris, Alvarez Alexis, Freylersythe Sarah J, Penaloza Irlena, Pace Thaddeus W W, Sikorskii Alla

机构信息

College of Nursing, University of Arizona, 1305 N. Martin, Room 337, Tucson, AZ, 85721, USA.

The University of Arizona Cancer Center, Tucson, AZ, USA.

出版信息

J Cancer Surviv. 2021 Aug;15(4):607-619. doi: 10.1007/s11764-020-00954-z. Epub 2020 Nov 10.

DOI:10.1007/s11764-020-00954-z
PMID:33170481
Abstract

PURPOSE

Assess feasibility, acceptability, and preliminary efficacy of an integrated symptom management and lifestyle intervention (SMLI) to improve adherence to the American Cancer Society's (ACS) Guidelines on Nutrition and Physical Activity in Latina cancer survivors and their informal caregivers (dyads).

METHODS

Forty-five dyads were randomized to a 12-week telephone-delivered intervention or attention control. Intervention effects on nutrition, physical activity, symptom burden, and self-efficacy for symptom management were estimated using Cohen's ds.

RESULTS

Mean age was 64 for survivors and 53 for caregivers. Feasibility was demonstrated by the 63% consent rate out of approached dyads. The SMLI was acceptable for 98% of dyads. Among survivors, medium-to-large effect sizes were found for increased servings of total fruits and vegetables (d = 0.55), vegetables (d = 0.72), and decreased sugar intake (d = - 0.51) and medium clinically significant effect sizes for total minutes of physical activity per week (d = 0.42) and grams of fiber intake per day (d = 0.40) for intervention versus attention control. Additionally, medium-to-large intervention effects were found for the reduction of symptom burden (d = 0.74). For caregivers, medium-to-large intervention effects were found for reduced total sugar intake (d = - 0.60) and sugar intake from sugar-sweetened beverages (d = - 0.65); vegetable intake was increased with a medium effect size (d = 0.41).

CONCLUSION

SMLI was feasible and acceptable for both dyadic members. A larger, well-powered trial is needed to formally evaluate SMLI effectiveness.

IMPLICATIONS FOR CANCER SURVIVORS

Integrating symptom management with lifestyle behavior interventions may increase adherence to the ACS guidelines on nutrition and physical activity to prevent new and recurrent cancers.

摘要

目的

评估综合症状管理与生活方式干预(SMLI)对提高拉丁裔癌症幸存者及其非正式照护者(二元组)遵循美国癌症协会(ACS)营养与身体活动指南的可行性、可接受性和初步疗效。

方法

45个二元组被随机分为接受为期12周的电话干预组或注意力对照组。使用科恩d值估计干预对营养、身体活动、症状负担和症状管理自我效能的影响。

结果

幸存者的平均年龄为64岁,照护者为53岁。接近的二元组中有63%的同意率证明了可行性。98%的二元组认为SMLI是可接受的。在幸存者中,干预组与注意力对照组相比,总水果和蔬菜摄入量增加(d = 0.55)、蔬菜摄入量增加(d = 0.72)、糖摄入量减少(d = -0.51),每周身体活动总分钟数(d = 0.42)和每日纤维摄入量(d = 0.40)有中等至较大的效应量,且具有中等临床显著效应量。此外,干预对减轻症状负担有中等至较大的效果(d = 0.74)。对于照护者,干预对总糖摄入量减少(d = -0.60)和含糖饮料糖摄入量减少(d = -0.65)有中等至较大的效果;蔬菜摄入量增加,效应量中等(d = 0.41)。

结论

SMLI对二元组的两个成员来说都是可行且可接受的。需要进行一项更大规模、有充分效力的试验来正式评估SMLI的有效性。

对癌症幸存者的启示

将症状管理与生活方式行为干预相结合可能会提高对ACS营养与身体活动指南的遵循程度,以预防新发和复发性癌症。

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