Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA.
J Altern Complement Med. 2021 May;27(5):423-433. doi: 10.1089/acm.2020.0400. Epub 2021 Apr 27.
An important gap between randomized efficacy research and real-world implementation of complementary therapies is the role of patient preferences in influencing engagement and outcome. Several studies have highlighted the benefits of patient preference on health outcomes, but few have investigated the factors associated with preference for interventions, which may be critical to assure the success of program implementation. The current study sought to explore the factors associated with patient preference in an ongoing randomized preference-based trial of Mindfulness-Based Cancer Recovery (MBCR) versus Tai Chi/ (TCQ) (the Mindfulness and Tai Chi/ in Cancer Health [MATCH] study). A multi-method study design was used. A subsample of participants were purposely selected from the ongoing MATCH study to have representation from both intervention arms and from both men and women across different age groups. Open-ended, semi-structured qualitative interviews were conducted to explore the factors influencing initial patient preference. Interviews were transcribed verbatim and analyzed by using inductive thematic analysis. The treatment acceptability and preference measure was administered to determine patients' ratings of acceptability and credibility of both preferred and nonpreferred interventions. A total of 13 participants were interviewed prior to program attendance, with 8 (62%) preferring TCQ and 5 (38%) choosing MBCR. Major themes related to patients' preference for intervention included: (1) expectations about the preferred intervention; (2) knowledge of the intervention; (3) past experiences with the intervention; and (4) self-efficacy. Participants' mean treatment acceptability scores were higher for their preferred program than their nonpreferred program. Understanding the factors that influence cancer survivors' preference for mind-body interventions can augment health care providers' knowledge of the barriers and facilitators for successful implementation of interventions in clinical settings, as well as help patients make informed treatment decisions and improve satisfaction and outcomes. Clinical trial registration no.: NCT03641222.
随机疗效研究与补充疗法在实际中的实施之间存在一个重要差距,即患者偏好对参与度和结果的影响。有几项研究强调了患者偏好对健康结果的益处,但很少有研究调查与干预偏好相关的因素,这些因素对于确保项目实施的成功可能至关重要。本研究旨在探索正在进行的基于正念的癌症康复(MBCR)与太极/气功(TCQ)(正念与太极/癌症健康[MATCH]研究)的随机偏好试验中患者偏好的相关因素。采用多方法研究设计。从正在进行的 MATCH 研究中有意选择了参与者的一个子样本,以代表两个干预组,并代表不同年龄段的男性和女性。进行了开放式、半结构化的定性访谈,以探讨影响初始患者偏好的因素。访谈内容逐字记录并进行了归纳主题分析。使用治疗可接受性和偏好量表来确定患者对首选和非首选干预措施的可接受性和可信度的评分。在参加项目之前,共有 13 名参与者接受了访谈,其中 8 名(62%)人更喜欢 TCQ,5 名(38%)人选择 MBCR。与患者对干预措施的偏好相关的主要主题包括:(1)对首选干预措施的期望;(2)对干预措施的了解;(3)对干预措施的既往经验;(4)自我效能。参与者对首选方案的治疗可接受性评分均高于非首选方案。了解影响癌症幸存者对身心干预措施偏好的因素,可以增强医疗保健提供者对成功实施干预措施在临床环境中的障碍和促进因素的了解,帮助患者做出明智的治疗决策,并提高满意度和结果。临床试验注册号:NCT03641222。