Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Center for the Study of Human Aging and Development, Duke University, Durham, North Carolina, USA.
J Palliat Med. 2022 Jan;25(1):60-69. doi: 10.1089/jpm.2021.0081. Epub 2021 Aug 12.
Pain from advanced cancer can greatly reduce patients' physical, emotional, and spiritual well-being. To examine the feasibility and acceptability of a behavioral pain management intervention, Meaning-Centered Pain Coping Skills Training (MCPC). This trial used a single-arm feasibility design. Thirty participants with stage IV solid tumor cancer, moderate-to-severe pain, and clinically elevated distress were enrolled from a tertiary cancer center in the United States. The manualized protocol was delivered across four 45- to 60-minute videoconference sessions. Feasibility and acceptability were assessed through accrual, session/assessment completion, intervention satisfaction, and coping skills usage. Participants completed validated measures of primary outcomes (i.e., pain severity, pain interference, and spiritual well-being) and secondary outcomes at baseline, post-intervention, and four-week follow-up. Eighty-eight percent (38/43) of patients who completed screening met inclusion criteria, and 79% (30/38) consented and completed baseline assessment. Sixty-seven percent (20/30) of participants were female (mean age = 57). Most participants were White/Caucasian (77%; 23/30) or Black/African American (17%; 5/30) with at least some college education (90%; 27/30). Completion rates for intervention sessions and both post-intervention assessments were 90% (27/30), 87% (26/30), and 77% (23/30), respectively. At the post-intervention assessment, participants reported a high degree of intervention satisfaction (mean = 3.53/4.00; SD = 0.46), and 81% (21/26) reported weekly use of coping skills that they learned. Participants also showed improvement from baseline on all primary outcomes and nearly all secondary outcomes at both post-intervention assessments. MCPC demonstrated strong feasibility and acceptability. Findings warrant further evaluation of MCPC in a randomized controlled trial. ClinicalTrials.gov Identifier: NCT03207360.
晚期癌症引起的疼痛会极大地降低患者的身体、情感和精神健康。为了检验一种行为疼痛管理干预措施——以意义为中心的疼痛应对技能训练(MCPC)的可行性和可接受性,本试验采用了单臂可行性设计。30 名来自美国一家三级癌症中心的患有 IV 期实体瘤癌症、中重度疼痛和临床显著焦虑的参与者参与了本试验。这个方案经过了 4 次 45 到 60 分钟的视频会议。通过入组、课程/评估完成、干预满意度和应对技能使用来评估可行性和可接受性。参与者在基线、干预后和四周随访时完成了主要结局(即疼痛严重程度、疼痛干扰和精神健康)和次要结局的有效验证。88%(43 名患者中的 38 名)完成了筛选符合纳入标准,且 79%(38 名中的 30 名)同意并完成了基线评估。30 名参与者中有 67%(20 名)为女性(平均年龄 57 岁)。大多数参与者为白种人/高加索人(77%;23 名中的 20 名)或非裔美国人(17%;23 名中的 5 名),至少受过一些大学教育(90%;27 名中的 23 名)。干预课程和两次干预后评估的完成率分别为 90%(30 名中的 27 名)、87%(30 名中的 26 名)和 77%(30 名中的 23 名)。在干预后评估时,参与者报告了很高的干预满意度(平均 3.53/4.00;标准差 0.46),81%(26 名中的 21 名)报告每周使用他们所学的应对技能。在两次干预后评估时,参与者在所有主要结局和几乎所有次要结局上都较基线有了改善。MCPC 表现出很强的可行性和可接受性。这些发现证明了在随机对照试验中进一步评估 MCPC 的必要性。ClinicalTrials.gov 标识符:NCT03207360。