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随机临床试验:一项针对接受高风险癌症治疗的青少年/年轻成人的父母的自我护理和沟通干预:来自儿童肿瘤学组的报告。

Randomized Clinical Trial of a Self-care and Communication Intervention for Parents of Adolescent/Young Adults Undergoing High-Risk Cancer Treatment: A Report From the Children's Oncology Group.

机构信息

Author Affiliations: Indiana University School of Nursing (Drs Haase and Robb, and Ms Henley), Indianapolis; Children's Mercy Hospital (Dr Stegenga), Kansas City, Missouri; Children's Minnesota (Dr Hooke and Ms Mitby); and University of Minnesota School of Nursing (Dr Hooke), Minneapolis; Purdue School of Engineering and Technology, IUPUI (Dr Burns), Indianapolis, Indiana; Department of Biostatistics & Health Data Science Indiana University Schools of Medicine & Public Health (Dr Monahan), Indianapolis; Department of Biostatistics, Indiana University School of Medicine (Mr Stump), Indianapolis; Riley Hospital for Children at IU Health, Department of Pediatrics, Indiana University School of Medicine (Dr Haut), Indianapolis; Aflac Cancer & Blood Disorders, Children's Healthcare of Atlanta (Dr Cherven), Georgia; Emory University School of Medicine (Dr Cherven), Atlanta, Georgia; University of Texas Health Science Center at San Antonio (Ms Roll, Dr Langevin, and Ms Diaz); The Ohio State University (Dr Pickler), Columbus; Cook Children's Medical Center (Dr Albritton), Fort Worth, Texas; Cincinnati Children's Hospital Medical Center, Ohio (Dr Hawkins, Ms Osterkamp, and Ms Moore); Piedmont Healthcare, Inc (Ms Smith), Atlanta, Georgia; and Jazz Pharmaceuticals (Dr Garcia-Frausto), Palo Alto, California.

出版信息

Cancer Nurs. 2022;45(4):316-331. doi: 10.1097/NCC.0000000000001038. Epub 2021 Nov 24.

Abstract

BACKGROUND

Parents of adolescents and young adults (AYAs) with cancer offer primary support to their children and often experience their own high levels of distress, affecting parent-AYA communication and quality of life.

OBJECTIVE

To reduce parent distress and improve communication during high-risk cancer treatment, we examined efficacy of a self-care and communication intervention for parents and indirect benefit for AYAs receiving a therapeutic music video (TMV) intervention.

METHODS

In this study, we conducted a multisite, randomized controlled trial with AYAs and parents enrolled as dyads (n = 110). Parents were randomized to intervention or low-dose control; all AYAs received TMV. Data collection occurred at baseline, 2 weeks post intervention (T2), and 90 days post intervention (T3).

RESULTS

There were no significant between-group differences on primary outcomes for parents or AYAs. We did find significant differences favoring the parent intervention group on parenting confidence at T2 and marginally better outcomes for family adaptability/cohesion at T3. Both groups exhibited significant within-group improvement for parent distress (state anxiety, T3; perceived stress, T2 and T3; mood, T3), state anxiety (T2) intervention only, and family strengths control group only. Qualitative data demonstrate the parent intervention raised self-awareness and parent confidence in the short term.

CONCLUSION

Parents found their intervention helpful. Absence of significant results may be due to short intervention duration, need for tailored content, underpowered sample, and potential indirect parent benefit from AYA participation in TMV. The parent intervention did not provide an indirect benefit for AYAs.

IMPLICATIONS FOR NURSING

Parents identified their own need for communication and support from nurses. Nurses can optimize AYA care by attending to parent needs through supportive listening and encouraging self-care.

摘要

背景

青少年和年轻成年人(AYAs)癌症患者的父母为其子女提供主要支持,并且经常经历自身的高度困扰,影响父母与 AYA 的沟通和生活质量。

目的

为了减少父母在高危癌症治疗期间的困扰并改善沟通,我们研究了一种自我护理和沟通干预措施对父母的效果,以及该干预措施对接受治疗性音乐视频(TMV)干预的 AYA 的间接益处。

方法

在这项研究中,我们进行了一项多站点、随机对照试验,将 AYA 和父母作为对子(n=110)进行招募。父母被随机分配到干预组或低剂量对照组;所有 AYA 均接受 TMV。数据收集在基线、干预后 2 周(T2)和干预后 90 天(T3)进行。

结果

父母和 AYA 的主要结局均无显著组间差异。我们确实发现,父母干预组在 T2 时的育儿信心有显著优势,在 T3 时家庭适应性/凝聚力的结果也略好。两组的父母焦虑(T3)、状态焦虑(T2)干预仅、压力感知(T2 和 T3)和情绪(T3)均有显著的组内改善,以及家庭力量对照组也有显著的组内改善。定性数据表明,该父母干预在短期内提高了自我意识和父母的信心。

结论

父母认为他们的干预措施很有帮助。没有显著的结果可能是由于干预时间短、需要定制内容、样本量不足以及 AYA 参与 TMV 对父母的潜在间接益处。该父母干预措施并未为 AYA 提供间接益处。

意义

父母表示他们需要护士提供沟通和支持。护士可以通过倾听支持和鼓励自我护理来满足父母的需求,从而优化 AYA 的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62e8/9208813/aecb9b82823d/cn-45-316-g001.jpg

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