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基于远程和门诊混合的干预措施以改善乳腺癌患者的日常参与度:一项试点随机对照试验。

Hybrid Tele and In-Clinic Occupation Based Intervention to Improve Women's Daily Participation after Breast Cancer: A Pilot Randomized Controlled Trial.

机构信息

Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel.

Clalit Health Services, Haifa and Western Galilee, Tel Aviv 62098, Israel.

出版信息

Int J Environ Res Public Health. 2021 Jun 2;18(11):5966. doi: 10.3390/ijerph18115966.

Abstract

BACKGROUND

Women after breast cancer (BC) cope with decreased daily participation and quality of life (QOL) due to physical, cognitive, and emotional symptoms. This study examined a hybrid occupation-based intervention, Managing Participation with Breast Cancer (MaP-BC), to improve daily participation in their meaningful activities.

METHODS

Thirty-five women after BC phase were randomly allocated to the MaP-BC intervention ( = 18) or control ( = 17) group (standard care only). Assessments were administered at baseline (T1), 6-week (T2), and 12-week (T3) post-T1.

MAIN OUTCOME

perceived performance and performance-satisfaction with meaningful activities according to the Canadian Occupational Performance Measure.

SECONDARY OUTCOMES

retained activity levels (Activity Card Sort), QOL (Functional Assessment of Cancer Therapy-Breast), cognitive abilities (Montreal Cognitive Assessment and Behavior Rating Inventory of Executive Function), and upper-extremity functioning (Disability of Arm, Shoulder, Hand). Results showed significant interaction (group x time) effects for the primary outcome in performance, F(2,66) = 29.54, = 0.001, ɳ = 0.472, and satisfaction, F(2,66) = 37.15, = 0.000, ɳ = 0.530. The intervention group improved more in performance, t = 5.51, = 0.0001, d = 1.298, and satisfaction, t = -5.32, = 0.0001, d = 1.254, than the control group between T1 and T2. Secondary outcomes demonstrated within-group improvements.

CONCLUSION

MaP-BC, a comprehensive occupation-based hybrid intervention tailored to women's functional daily needs after BC, improved participation in meaningful activities within a short period.

摘要

背景

乳腺癌(BC)后的女性由于身体、认知和情绪症状而导致日常参与度和生活质量(QOL)下降。本研究探讨了一种混合基于职业的干预措施,即乳腺癌参与管理(MaP-BC),以改善其参与有意义活动的日常能力。

方法

35 名乳腺癌后阶段的女性被随机分配到 MaP-BC 干预组(n=18)或对照组(n=17)(仅接受标准护理)。在基线(T1)、6 周(T2)和 12 周(T3)后进行评估。

主要结果

根据加拿大职业表现量表,评估对有意义活动的感知表现和表现满意度。

次要结果

保留的活动水平(活动卡片分类)、QOL(癌症治疗-乳房功能评估)、认知能力(蒙特利尔认知评估和行为评定量表的执行功能)和上肢功能(手臂、肩膀、手的残疾)。结果显示,主要结果的表现和满意度方面的组间交互(group x time)效应显著,F(2,66) = 29.54,p=0.001,ɳ=0.472,F(2,66) = 37.15,p<0.0001,ɳ=0.530。干预组在表现方面的改善更为显著,t=5.51,p=0.0001,d=1.298,满意度方面的改善也更为显著,t=-5.32,p<0.0001,d=1.254,与对照组相比,在 T1 到 T2 之间。次要结果显示出组内的改善。

结论

MaP-BC 是一种针对乳腺癌后女性日常功能需求的综合基于职业的混合干预措施,可在短时间内提高有意义活动的参与度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cf2/8199623/0326544c89a2/ijerph-18-05966-g001.jpg

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