School of Nursing and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH.
Case Western Reserve University, School of Nursing, Cleveland, OH.
JCO Oncol Pract. 2021 Jan;17(1):e26-e35. doi: 10.1200/OP.20.00576.
Approximately 20% of caregivers (CGs) live > 1 hour away from the patient and are considered distance caregivers (DCGs) who often report higher distress and anxiety than local CGs. The purpose of this study was to test the effectiveness of an intervention aimed at reducing anxiety and distress in DCGs of patients with cancer.
This randomized controlled trial enrolled DCGs of patients with all cancer types who were being seen monthly by oncologists in outpatient clinics. There were three arms of the intervention delivered over a 4-month period: arm 1 (a) received 4 monthly videoconference-tailored coaching sessions with an advanced practice nurse or social worker focused on information and support, (b) participated in patient's appointments with the oncologist via videoconference over the 4-month study period, and (c) had access to a website designed for DCGs. Arm 2 did not receive the coaching sessions but received the other two components, and arm 3 received access to the DCG website only.
There were 302 DCGs who provided pre- and postintervention data. There were significant anxiety by group ( = .028 and = 0.16) and distress by group interactions ( = .014 and = 0.17). Arm 1 had the greatest percentage of DCGs who demonstrated improvement in anxiety (18.6%) and distress (25.2%).
Coaching and use of videoconference technology (to join the DCG into the patient-oncologist office visit) were effective in reducing both anxiety and distress for DCGs. These components could be considered for local CGs who-with COVID-19-are unable to accompany the patient to oncologist visits.
大约 20%的照顾者(CGs)与患者的距离超过 1 小时,被认为是远距离照顾者(DCGs),他们往往比当地的 CGs 报告更高的痛苦和焦虑。本研究的目的是测试一种旨在减少癌症患者 DCGs 焦虑和痛苦的干预措施的有效性。
这项随机对照试验招募了所有癌症类型患者的 DCGs,这些患者每月在门诊由肿瘤学家就诊。干预措施分为三个阶段,持续 4 个月:第 1 组(a)接受 4 次每月的视频会议定制的护理人员或社会工作者辅导会议,重点是信息和支持,(b)在 4 个月的研究期间通过视频会议参加患者与肿瘤学家的预约,(c)可以访问专为 DCGs 设计的网站。第 2 组不接受辅导课程,但接受了其他两个组成部分,第 3 组仅访问 DCG 网站。
共有 302 名 DCGs 提供了干预前后的数据。焦虑存在显著的组间差异( =.028, = 0.16)和困扰的组间交互作用( =.014, = 0.17)。第 1 组有最大比例的 DCGs 焦虑(18.6%)和困扰(25.2%)得到改善。
辅导和使用视频会议技术(将 DCG 加入 DCG-患者-肿瘤学家就诊)对减轻 DCGs 的焦虑和困扰都很有效。在 COVID-19 期间,这些组成部分可以考虑用于无法陪同患者去看肿瘤学家的当地 CGs。