Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA.
Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA.
J Cancer Surviv. 2024 Apr;18(2):398-411. doi: 10.1007/s11764-022-01227-7. Epub 2022 Jun 27.
Head and neck cancer (HNC) survivors and caregivers face significant challenges after treatment. This study's objective was to evaluate the effects of a dyadic survivorship care planning (SCP) intervention on survivor and caregiver outcomes.
This randomized controlled trial enrolled HNC survivors and caregivers within 18 months post-treatment, randomized dyads to SCP (one-session with written SCP and follow-up telephone call) or usual care and administered baseline and 6-month surveys. Multivariable linear regression examined intervention effects on depression and unmet needs in dyads and burden on caregiverss and a set of secondary outcomes. Rating scales and open-ended questions assessed acceptability.
We randomized 89 survivor-caregiver dyads (42 usual care, 47 SCP dyads). Fidelity to SCP was high for most survivorship domains except discussing care barriers (13%). The most commonly discussed referrals included nutrition (83%) and behavioral medicine (38%), but referral uptake was low. The SCP intervention did not improve depression or unmet needs among dyads or burden among caregivers at 6 months relative to usual care (p's > .05). Nurses and dyads rated SCP favorably with > 80% positive ratings for session length and care plan content. Qualitative findings highlighted that SCP helped consolidate complex clinical information and strengthened survivor-caregiver-clinician relationships.
An HNC SCP intervention was acceptable but ineffective in improving dyads' outcomes.
Post-treatment SCP in HNC dyads was ineffective in improving outcomes in survivors and caregivers as delivered in this study. More research is needed to understand how to capitalize on the acceptability of the SCP approach and enhance its effectiveness to support dyads.
头颈部癌症（HNC）幸存者及其照顾者在治疗后面临重大挑战。本研究旨在评估双元生存照护计划（SCP）干预对幸存者和照顾者结局的影响。
本随机对照试验纳入了治疗后 18 个月内的 HNC 幸存者及其照顾者，将双元随机分为 SCP（一次会议及书面 SCP 和后续电话随访）或常规护理，并在基线和 6 个月时进行调查。多变量线性回归分析了干预对双元组抑郁和未满足需求的影响，以及对照顾者负担和一系列次要结局的影响。评分量表和开放式问题评估了可接受性。
我们随机分配了 89 对幸存者-照顾者双元（42 对常规护理，47 对 SCP 双元）。除了讨论护理障碍（13%）外，大多数生存领域的 SCP 都保持了高保真度。讨论最多的转介包括营养（83%）和行为医学（38%），但转介接受率较低。与常规护理相比，SCP 干预在 6 个月时并未改善双元组的抑郁或未满足需求，也未减轻照顾者的负担（p>0.05）。护士和双元组对 SCP 的评价非常好，对会议时长和护理计划内容的正面评价超过 80%。定性研究结果强调，SCP 有助于整合复杂的临床信息，并加强了幸存者-照顾者-临床医生之间的关系。
HNC 的 SCP 干预在改善双元结局方面是可行的，但无效。
在本研究中，HNC 双元组的 SCP 在改善幸存者和照顾者结局方面是无效的。需要进一步研究以了解如何利用 SCP 方法的可接受性并增强其有效性，以支持双元组。
