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共同设计一项行为干预措施,以减轻化疗引起的周围神经病变症状的影响:一种基于证据和理论的方法。

Co-designing a behavioural intervention for reducing the impact of chemotherapy-induced peripheral neuropathy symptoms: An evidence- and theory-driven approach.

机构信息

Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.

School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.

出版信息

Eur J Cancer Care (Engl). 2022 Nov;31(6):e13671. doi: 10.1111/ecc.13671. Epub 2022 Aug 12.

Abstract

OBJECTIVE

This study aims to co-design an evidence- and theory-based behavioural intervention to reduce the impact of chemotherapy-induced peripheral neuropathy (CIPN) symptoms on patients' quality of life.

METHODS

Guided by the Medical Research Council Framework for developing and evaluating complex interventions, our intervention development process was guided by (a) findings of systematic reviews, (b) inductive analysis of 39 h of observational fieldwork, 12 patient and 11 clinician interviews, (c) deductive analysis using the Common-Sense Model to develop a Self-Regulation Model of CIPN and (d) 17 patients and 18 clinicians co-designing the intervention.

RESULTS

CIPN perception and coping behaviours were highlighted as processes to target when co-designing an intervention. The processes targeted in our intervention are CIPN perception and coping behaviours, namely, (a) self-monitoring of symptoms, (b) communicating and early reporting of symptoms to clinicians, (c) participating in making chemotherapy dose reduction decisions with their clinicians and (d) engaging in self-management and safety strategies to reduce impact of CIPN symptoms. To address these, a behavioural intervention was deemed suitable.

CONCLUSION

We developed a self-regulation model of CIPN and a logic model for documenting the proposed mechanism of action of our co-designed behavioural intervention for reducing impact of CIPN symptoms.

摘要

目的

本研究旨在共同设计一种基于证据和理论的行为干预措施,以减轻化疗引起的周围神经病(CIPN)症状对患者生活质量的影响。

方法

本研究以医学研究委员会制定和评估复杂干预措施的框架为指导,通过以下方式指导我们的干预措施的开发过程:(a)系统评价的结果;(b)39 小时观察性实地工作、12 名患者和 11 名临床医生访谈的归纳分析;(c)使用常识模型进行演绎分析,以制定 CIPN 的自我调节模型;(d)17 名患者和 18 名临床医生共同设计干预措施。

结果

CIPN 的感知和应对行为被强调为共同设计干预措施时需要针对的过程。我们的干预措施针对的过程是 CIPN 的感知和应对行为,即(a)症状的自我监测;(b)与临床医生沟通并早期报告症状;(c)参与与临床医生一起做出化疗剂量减少决定;(d)参与自我管理和安全策略以减轻 CIPN 症状的影响。为了解决这些问题,认为行为干预是合适的。

结论

我们开发了 CIPN 的自我调节模型和逻辑模型,以记录我们共同设计的行为干预措施减轻 CIPN 症状影响的拟议作用机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81ac/9786800/f810a9689841/ECC-31-e13671-g003.jpg

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