Department of Behavioral Science, Markey Cancer Center, Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
University of Kentucky College of Medicine, Lexington, Kentucky, USA.
Psychooncology. 2021 Jun;30(6):863-873. doi: 10.1002/pon.5650. Epub 2021 Feb 26.
Between 40% and 65% of lung cancer patients report concern about maintaining valued activities and roles, yet few interventions address this concern. Hope, a patient's perceived ability to generate goals and identify ways to pursue them, may be a promising intervention target to support function among lung cancer patients. The goal of this study was to assess metastatic non-small cell lung cancer (mNSCLC) patient interest and preferences for a hope-enhancing intervention.
We conducted a sequential mixed-methods (survey followed by semi-structured interviews) study with patients with mNSCLC. Surveys assessed patient interest in, perceived helpfulness of, and preferences for a hope intervention. A subset of 12 patients (and caregivers, when present) completed semi-structured interviews to elicit feedback on proposed intervention content and procedures.
Survey data from 60 patients (40% male; Mean age = 62.5; SD = 9.3) suggested high perceived importance of pursuing personal goals during cancer treatment, moderate perceived helpfulness in discussing personal goals, and preference for a nurse-led intervention. Based on these data, a 5-session, nurse-led intervention protocol was drafted and reviewed with 12 patients. Interviewed patients and caregivers agreed working towards goals was beneficial, liked the intervention concept, and thought prompts and rating scales on handouts would facilitate discussion. The majority preferred nurse delivery during infusions.
A nurse-led hope-enhancing intervention delivered primarily during infusions may be acceptable to mNSCLC patients. Future work should test feasibility and identify ways to incorporate caregivers and oncology providers into hope interventions.
40%至 65%的肺癌患者表示关注维持有价值的活动和角色，但很少有干预措施解决这一问题。希望是患者感知自己产生目标和识别追求目标方法的能力，可能是支持肺癌患者功能的一个很有前途的干预目标。本研究的目的是评估转移性非小细胞肺癌（mNSCLC）患者对增强希望干预措施的兴趣和偏好。
我们对 mNSCLC 患者进行了一项顺序混合方法（调查后进行半结构式访谈）研究。调查评估了患者对希望干预措施的兴趣、感知有用性和偏好。12 名患者（有照顾者的情况下）完成了半结构式访谈，以获取对拟议干预内容和程序的反馈。
60 名患者（40%为男性；平均年龄为 62.5 岁，标准差为 9.3）的调查数据表明，在癌症治疗期间追求个人目标的重要性很高，讨论个人目标的感知有用性中等，且倾向于选择护士主导的干预措施。基于这些数据，制定了一个 5 节、由护士主导的干预方案，并与 12 名患者进行了审查。接受访谈的患者和照顾者都认为朝着目标努力是有益的，喜欢干预的概念，并认为提示和评分表会有助于讨论。大多数人倾向于在输液时由护士提供干预。
主要在输液期间由护士提供的增强希望的干预措施可能被 mNSCLC 患者接受。未来的工作应该测试可行性，并确定将照顾者和肿瘤学提供者纳入希望干预措施的方法。
