Thompson Tess, Pérez Maria, Yan Yan, Kreuter Matthew W, Margenthaler Julie A, Colditz Graham A, Jeffe Donna B
Brown School of Social Work, Washington University in St. Louis, USA.
Washington University School of Medicine, USA.
Soc Sci Med. 2021 Feb;270:113663. doi: 10.1016/j.socscimed.2020.113663. Epub 2020 Dec 29.
Video-based interventions hold promise for improving quality of life (QoL) among African American breast cancer patients.
An interactive, cancer-communication intervention using African American breast cancer survivors' narratives was tested in a randomized controlled trial to determine whether viewing survivor stories improved newly diagnosed African American breast cancer patients' QoL.
Participants were 228 African American women with non-metastatic breast cancer interviewed five times over two years; 120 controls received standard medical care, and 108 intervention-arm participants also received a tablet-computer with survivor stories three times in 12 months. Growth curve models were used to analyze differences between arms in change in eight RAND 36-Item Health Survey subscales, depressive symptoms, and concerns about recurrence. Additional models explored the effects of intervention usage and other intervention-related variables on QoL among patients in the intervention arm.
Models showed no effect of study arm on QoL, depressive symptoms, or concerns about recurrence. Longer use of the intervention was associated with an increase in concerns about recurrence and decline in three QoL subscales: emotional wellbeing, energy/fatigue, and role limitations due to physical health.
Although no significant impact of the intervention on QoL was observed when comparing the two study arms, in the intervention arm longer intervention use was associated with declines in three QoL subscales and increased concerns about recurrence. Women with improving QoL may have interacted with the tablet less because they felt less in need of information; it is also possible that encouraging patients to compare themselves to survivors who had already recovered from breast cancer led some patients to report lower QoL. Future work is warranted to examine whether adding different stories to this cancer-communication intervention or using stories in conjunction with additional health promotion strategies (e.g., patient navigation) might improve QoL for African American breast cancer patients.
基于视频的干预措施有望改善非裔美国乳腺癌患者的生活质量（QoL）。
在一项随机对照试验中测试了一种使用非裔美国乳腺癌幸存者叙事的互动式癌症沟通干预措施，以确定观看幸存者故事是否能改善新诊断的非裔美国乳腺癌患者的生活质量。
参与者为228名患有非转移性乳腺癌的非裔美国女性，在两年内接受了五次访谈；120名对照组接受标准医疗护理，108名干预组参与者在12个月内还三次收到装有幸存者故事的平板电脑。使用增长曲线模型分析两组在8个兰德36项健康调查子量表、抑郁症状和对复发的担忧方面的变化差异。其他模型探讨了干预措施的使用情况和其他与干预相关的变量对干预组患者生活质量的影响。
模型显示研究组对生活质量、抑郁症状或对复发的担忧没有影响。干预措施使用时间越长，对复发的担忧增加，并且在三个生活质量子量表上下降：情绪健康、精力/疲劳以及由于身体健康导致的角色限制。
虽然在比较两个研究组时未观察到干预措施对生活质量有显著影响，但在干预组中，干预措施使用时间越长，三个生活质量子量表下降，对复发的担忧增加。生活质量改善的女性可能与平板电脑的互动较少，因为她们觉得对信息的需求较小；也有可能鼓励患者将自己与已经从乳腺癌中康复的幸存者进行比较，导致一些患者报告较低的生活质量。未来有必要开展工作，研究在这种癌症沟通干预措施中添加不同的故事或结合其他健康促进策略（如患者导航）是否可能改善非裔美国乳腺癌患者的生活质量。
