Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA.
J Adolesc Young Adult Oncol. 2023 Aug;12(4):472-487. doi: 10.1089/jayao.2022.0100. Epub 2022 Sep 30.
Improved symptom management is a critical although unmet post-treatment need for young adult (YA) cancer survivors (aged 18-39 at diagnosis). This study aimed to develop and refine a behavioral symptom management intervention for YA survivors. Phase I: YA survivors ( = 21) and oncology providers ( = 11) completed individual interviews and an online, self-report assessment to examine symptom experiences, the need for a behavioral symptom management intervention for YAs, and perceptions about potential intervention components, structure, and format. Phase II: YA survivors ( = 10) completed user testing sessions, providing feedback on the prototype intervention materials (paper manual and mobile application), and completed an online assessment. Quantitative data were examined using descriptive statistics. Rapid qualitative analysis, a methodologically rigorous standardized approach, was used. Pain, fatigue, and distress were ranked as top concerns by most YAs and providers. Phase I interviews underscored the need for a symptom management intervention for YAs. YAs and providers highlighted potential coping strategies and program format/structure suggestions (e.g., small group format) to best meet YAs' needs. A prototype intervention was developed combining the following: traditional behavioral symptom coping skills; home-based physical activity; strategies from Acceptance and Commitment Therapy and Meaning-Centered Psychotherapy; and strategies to foster self-compassion. Phase II user testing sessions highlighted strengths and suggestions for refining the prototype materials. Post-treatment symptoms are common for YAs. A tailored behavioral symptom management program was developed and refined with input from YAs and providers and will be examined for feasibility and acceptability in a pilot randomized controlled trial. Clinicaltrials.gov identifier NCT04035447.
改善症状管理是青少年癌症幸存者(诊断时年龄为 18-39 岁)的一项重要但未得到满足的治疗后需求。本研究旨在为青少年癌症幸存者开发和完善一种行为症状管理干预措施。
21 名青少年癌症幸存者和 11 名肿瘤学提供者完成了个人访谈和在线自我报告评估,以检查症状体验、青少年对行为症状管理干预的需求以及对潜在干预措施组成部分、结构和格式的看法。第二阶段:10 名青少年癌症幸存者完成了用户测试会议,对原型干预材料(纸质手册和移动应用程序)提供反馈,并完成了在线评估。使用描述性统计数据检查定量数据。使用快速定性分析(一种方法严谨的标准化方法)对数据进行分析。疼痛、疲劳和困扰是大多数青少年和提供者最关心的问题。第一阶段的访谈强调了为青少年开发症状管理干预措施的必要性。青少年和提供者强调了潜在的应对策略和计划格式/结构建议(例如,小组格式),以最好地满足青少年的需求。结合以下内容开发了一个原型干预措施:传统的行为症状应对技巧;基于家庭的体育活动;接受与承诺疗法和意义中心心理疗法的策略;以及培养自我同情的策略。第二阶段的用户测试会议强调了原型材料的优势和改进建议。治疗后症状在青少年中很常见。在青少年和提供者的意见的基础上制定并完善了一个针对性的行为症状管理方案,并将在一项小型随机对照试验中对其可行性和可接受性进行检验。Clinicaltrials.gov 标识符:NCT04035447。