一项针对肺癌患者的 Inspire Now：计划的前瞻性结局试点评估。
A Prospective Outcomes Pilot Evaluation of Inspire Now: A Program for People with Lung Cancer.
机构信息
Ottawa Integrative Cancer Centre, Ottawa, ON, Canada.
Canadian College of Naturopathic Medicine, Toronto, ON, Canada.
出版信息
Integr Cancer Ther. 2020 Jan-Dec;19:1534735420983472. doi: 10.1177/1534735420983472.
BACKGROUND
Lung cancer is the leading cause of cancer mortality in Canada, yet patients are often under-supported. A six-week program called Inspire Now, created to address unmet supportive care needs, was evaluated in this study. Feasibility and preliminary outcomes were assessed in order to inform future changes to the program.
OBJECTIVES
(1) Assess the feasibility of the program and its evaluation; (2) pilot the collection of patient-reported outcomes; (3) identify outcomes that may be positively influenced; and (4) inform program modifications.
METHODS
Participants were recruited from the first session of Inspire Now for an observational pilot study. The primary outcome was feasibility. Secondary outcomes included within-person changes in Functional Assessment of Cancer Therapy - Lung (FACT-L) and Measure Yourself Concerns and Wellbeing (MYCaW), and program satisfaction and qualitative experiences of participants and facilitators through internally-developed questionnaires and semi-structured interviews. Analysis was primarily descriptive, within person changes in FACT-L and MYCaW were analyzed using the Wilcoxon signed-rank test and qualitative data was assessed for common themes.
RESULTS
The program and its evaluation were feasible; 8 of 9 (89%) participants consented to the study, median attendance was 6 of 6 sessions (IQR 4.5-6), and questionnaire completion was 100% at baseline and 75% at follow-up. There were clinically meaningful improvements in MYCaW concern 1 (-1.2, 95% CI -2.0 to -0.4) and overall wellbeing (-0.9, 95% CI -2.1 to 0.4). Seven of eight FACT-L sub-sections trended toward improvement, with absolute changes ranging from -1.7 to 10.8%. Participant feedback was overwhelmingly positive; group support and social interactions were highly valued.
CONCLUSIONS
The group intervention for people with lung cancer was feasible to both run and evaluate. Participants responded positively to the program. Findings will inform changes to future sessions and an analysis of multiple sessions is planned.
背景
肺癌是加拿大癌症死亡的主要原因，但患者往往得不到充分的支持。为了解决未满足的支持性护理需求，开发了一个名为“Inspire Now”的六周计划，并在本研究中对其进行了评估。为了为计划的未来变更提供信息，评估了该计划的可行性和初步结果。
目的
（1）评估计划及其评估的可行性；（2）试点收集患者报告的结果；（3）确定可能受到积极影响的结果；（4）为计划修改提供信息。
方法
从“Inspire Now”的第一节课中招募参与者进行观察性试点研究。主要结果是可行性。次要结果包括个体内功能评估癌症治疗-肺（FACT-L）和测量自己的关注和幸福感（MYCaW）的变化，以及参与者和促进者通过内部开发的问卷和半结构化访谈对计划满意度和定性体验的评估。分析主要是描述性的，FACT-L 和 MYCaW 的个体内变化使用 Wilcoxon 符号秩检验进行分析，定性数据评估共同主题。
结果
计划及其评估具有可行性；9 名参与者中有 8 名（89%）同意参加研究，中位数出席率为 6 次/6 次（IQR 4.5-6），基线时问卷完成率为 100%，随访时为 75%。在 MYCaW 关注 1 项（-1.2，95%CI-2.0 至-0.4）和整体幸福感（-0.9，95%CI-2.1 至 0.4）方面均有临床意义上的改善。FACT-L 的七个亚组均呈改善趋势，绝对值变化范围为-1.7 至 10.8%。参与者的反馈非常积极；小组支持和社交互动受到高度重视。
结论
针对肺癌患者的小组干预既可行又可行。参与者对该计划反应积极。研究结果将为未来课程的变更提供信息，并计划对多个课程进行分析。
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