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头颈部癌症照顾者多模式自我管理干预的可行性和可接受性:一项先导随机试验。

Feasibility and Acceptability of a Multi-Modality Self-Management Intervention for Head and Neck Cancer Caregivers: A Pilot Randomized Trial.

机构信息

Wake Forest School of Medicine, Winston-Salem, NC, USA.

Medical University of South Carolina, Charleston, SC, USA.

出版信息

Integr Cancer Ther. 2022 Jan-Dec;21:15347354221098984. doi: 10.1177/15347354221098984.

Abstract

BACKGROUND

Head and neck cancer (HNC) patients undergoing radiation therapy (RT) experience significant side effects, presenting challenging care tasks for their informal (unpaid) caregivers. HNC caregivers report low caregiving self-efficacy, high distress, and interest in supportive care interventions.

OBJECTIVE

This randomized pilot trial assessed the feasibility and acceptability of a 6 to 7 week supported self-management intervention (Prepare to Care) offering psychoeducation and stress management skills building for caregivers of patients receiving RT for HNC.

METHODS

Caregivers were randomized to Prepare to Care or standard of care. Primary feasibility measures included participation and retention percentages. Assessments were completed before the intervention, at intervention completion, and 6-weeks later after intervention completion.

RESULTS

Caregivers (N = 38) were predominantly female (88.6%), an average age of 56 years old, and a spouse/partner to the patient (71.4%). Participation percent was 42.2%; retention at intervention conclusion was 80% and 77% at the 6-week follow-up. Quantitative and qualitative results support acceptability, with 64% to 88% reporting each intervention module was helpful (quite a bit or very). Intervention caregivers reported a significantly greater improvement in self-efficacy for progressive muscle relaxation (PMR).

CONCLUSIONS

Prepare to Care and the randomized pilot trial methods are feasible and acceptable for HNC caregivers of patients receiving RT. A significant treatment effect was observed for self-efficacy for PMR, and findings were in the expected direction regarding improved caregiving self-efficacy. Further research is necessary to determine the efficacy of this intervention with a focus on increased engagement strategies and longer-term outcomes.

TRIAL REGISTRATION

NCT03032250.

摘要

背景

接受放射治疗(RT)的头颈部癌症(HNC)患者会经历严重的副作用,这给他们的非专业(无报酬)照顾者带来了具有挑战性的护理任务。HNC 照顾者报告说他们的照顾自我效能感较低,压力较大,并且对支持性护理干预措施感兴趣。

目的

这项随机试点试验评估了为期 6 至 7 周的支持性自我管理干预措施(准备护理)的可行性和可接受性,该干预措施为接受 HNC RT 的患者的照顾者提供心理教育和压力管理技能培训。

方法

照顾者被随机分配到准备护理或标准护理组。主要可行性指标包括参与率和保留率。评估在干预前、干预完成时和干预完成后 6 周进行。

结果

照顾者(N=38)主要为女性(88.6%),平均年龄为 56 岁,是患者的配偶/伴侣(71.4%)。参与率为 42.2%;干预结束时的保留率为 80%,6 周随访时为 77%。定量和定性结果均支持可接受性,有 64%至 88%的人报告说每个干预模块都有帮助(相当有帮助或非常有帮助)。干预组的照顾者报告说,渐进性肌肉松弛(PMR)的自我效能感有显著提高。

结论

准备护理和随机试点试验方法对头颈部癌症接受 RT 治疗的患者的照顾者是可行和可接受的。PMR 的自我效能感观察到显著的治疗效果,并且在提高照顾自我效能感方面的结果与预期方向一致。需要进一步的研究来确定该干预措施的疗效,重点是增加参与策略和长期结果。

试验注册

NCT03032250。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d61/9121462/8f6739783106/10.1177_15347354221098984-fig1.jpg

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