VA Puget Sound Health Care System, 9600 Veterans Dr SW, Tacoma, WA, 98493, USA.
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA.
J Clin Psychol Med Settings. 2023 Mar;30(1):182-196. doi: 10.1007/s10880-022-09874-9. Epub 2022 May 13.
Psychosocial interventions for breast-cancer-related pain are effective, yet over 45% of survivors continue to struggle with this often-chronic side effect. This study evaluated multilevel indicators that can influence successful translation of interventions into clinical practice. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was applied to evaluate reporting of individual and setting/staff-level intervention indicators. A systematic search and multi-step screening process identified 31 randomized controlled trials for psychosocial interventions for breast cancer-related pain. Average reporting of indicators for individual-level dimensions (Reach and Effectiveness) were 65.2% and 62.3%, respectively. Comparatively, indicators for setting/staff-level dimensions were reported at a lower average frequency (Implementation, 46.8%; Adoption, 15.2%; Maintenance, 7.7%). Low reporting of setting/staff-level dimensions suggests gaps in the sustained implementation of psychosocial interventions. Implementation science methods and frameworks could improve trial design and accelerate the translation of psychosocial interventions for breast cancer-related pain into clinical practice.
针对乳腺癌相关疼痛的心理社会干预措施是有效的，但超过 45%的幸存者仍在苦苦应对这种常见的慢性副作用。本研究评估了可能影响干预措施成功转化为临床实践的多层次指标。采用 Reach、Effectiveness、Adoption、Implementation 和 Maintenance（RE-AIM）框架来评估个体和环境/员工层面干预指标的报告情况。通过系统搜索和多步骤筛选过程，确定了 31 项针对乳腺癌相关疼痛的心理社会干预措施的随机对照试验。个体层面维度（Reach 和 Effectiveness）指标的平均报告率分别为 65.2%和 62.3%。相比之下，环境/员工层面维度的指标报告频率较低（Implementation 为 46.8%，Adoption 为 15.2%，Maintenance 为 7.7%）。环境/员工层面维度的低报告率表明心理社会干预措施的持续实施存在差距。实施科学方法和框架可以改进试验设计，并加速将针对乳腺癌相关疼痛的心理社会干预措施转化为临床实践。
