Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Pain Prevention and Treatment Research Program, Duke University Medical Center, 2200 W. Main Street, Suite 340, Durham, NC, 27705, USA.
Support Care Cancer. 2021 Sep;29(9):5361-5369. doi: 10.1007/s00520-021-06126-8. Epub 2021 Mar 8.
Colorectal cancer survivors report pain and psychological distress to be burdensome long-term cancer consequences. Quality cancer survivorship care includes interventions for managing these symptoms. Yet, no studies have tested the efficacy of an accessible behavioral intervention for colorectal cancer survivors with pain and comorbid psychological distress. This paper reports on the feasibility (i.e., accrual, attrition, and adherence to study procedures), engagement, acceptability, and descriptive outcomes of a telephone-based coping skills training (CST) intervention.
This randomized pilot trial assigned colorectal cancer patients (N=31) to 5 sessions of CST or standard care. CST sessions focused on cognitive-behavioral theory-based coping skills tailored to colorectal cancer symptoms of pain and psychological distress. Participants completed assessments of pain severity, self-efficacy for pain management, health-related quality of life, and psychological distress at baseline, post-treatment, and 3-month follow-up.
Data indicated strong feasibility, evidenced by high completion rates for intervention sessions and assessments (93% completed all sessions; M=48.7 days; baseline=100%; post-treatment=97%; 3-month follow-up=94%). Participants demonstrated robust engagement with CST (M days per week with reported skills use=3.8) and reported high protocol satisfaction (M=3.6/4.0). Descriptive statistics showed self-efficacy for pain management and health-related quality of life improved for all participants.
Findings suggest that a telephone-based CST intervention has strong feasibility, evidenced by accrual, low attrition, and adherence to intervention sessions and assessments. Likewise, participant engagement and acceptability with CST were high. These data provide a foundation for larger randomized efficacy trials of the telephone-based CST intervention.
结直肠癌幸存者报告疼痛和心理困扰是长期癌症后果的负担。高质量的癌症生存护理包括干预措施来管理这些症状。然而,没有研究测试过针对有疼痛和并存心理困扰的结直肠癌幸存者的易于获得的行为干预的疗效。本文报告了基于电话的应对技能培训(CST)干预的可行性(即入组、脱落和对研究程序的依从性)、参与度、可接受性和描述性结果。
这项随机试点试验将结直肠癌患者(N=31)随机分配到 CST 或标准护理 5 个疗程。CST 疗程侧重于基于认知行为理论的应对技能,针对结直肠癌的疼痛和心理困扰症状进行了调整。参与者在基线、治疗后和 3 个月随访时完成疼痛严重程度、疼痛管理自我效能感、健康相关生活质量和心理困扰的评估。
数据表明,干预疗程和评估的完成率很高,表明具有很强的可行性(93%完成了所有疗程;M=48.7 天;基线=100%;治疗后=97%;3 个月随访=94%)。参与者表现出对 CST 的强烈参与(M 每周报告使用技能的天数=3.8),并报告了很高的方案满意度(M=3.6/4.0)。描述性统计显示,所有参与者的疼痛管理自我效能感和健康相关生活质量都有所改善。
研究结果表明,基于电话的 CST 干预具有很强的可行性,体现在入组率高、脱落率低、以及对干预疗程和评估的依从性。同样,参与者对 CST 的参与度和可接受性也很高。这些数据为基于电话的 CST 干预的更大规模随机疗效试验提供了基础。