患者和物理治疗师对颈部解剖术后康复正确（GRRAND）康复干预的看法：一项在可行性试验中嵌入的定性访谈研究。

Patient and physiotherapist perceptions of the Getting Recovery Right After Neck Dissection (GRRAND) rehabilitation intervention: a qualitative interview study embedded within a feasibility trial.

机构信息

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

出版信息

BMJ Open. 2022 Nov 14;12(11):e064269. doi: 10.1136/bmjopen-2022-064269.

DOI:10.1136/bmjopen-2022-064269

PMID:36375975

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9664296/

Abstract

OBJECTIVE

The Getting Recovery Right After Neck Dissection (GRRAND) intervention is a physiotherapy programme for patients with head and neck cancer who have undergone neck dissection. The aim of this qualitative study was to understand if the intervention was useful, acceptable and whether it was feasible to conduct a randomised controlled trial (RCT).

DESIGN

This qualitative study was embedded within the GRRAND-Feasibility (GRRAND-F) Study.

SETTING

Participants were recruited from four acute National Health Service hospitals in England between 2020 and 2021.

PARTICIPANTS

We interviewed four usual care and four intervention patient-participants from a single study site (Oxford). Six were male, two were female. All were white British ethnicity. We interviewed two physiotherapists from Oxford who delivered the GRRAND-F intervention, and physiotherapists from Birmingham, Poole and Norwich who were trained to deliver the intervention but were not able to deliver it within the study time frame.

RESULTS

The analysis identified five themes: (1) Acceptability, (2) Adherence, (3) Outcomes, (4) Feasibility and (5) Stand-alone themes (prehabilitation, video consultations, healthcare use).Patient-participants and physiotherapist-participants agreed that usual care was not meeting patients' rehabilitation needs. The GRRAND intervention provided biopsychosocial support. In comparison to the usual care group, patient-participants who received the intervention were more confident that they could perform rehabilitation exercises and were more motivated to engage in long-term adaptive behaviour change. Physiotherapists felt they needed more administrative support to participate in an RCT.

CONCLUSION

Participants felt that usual care was insufficient. GRRAND provided much needed, biopsychosocial support to patients. Participants were supportive that it would be feasible to test GRRAND in an RCT.

TRIAL REGISTRATION NUMBER

ISRCTN11979997.

摘要

目的

颈部清扫术后恢复正确（GRRAND）干预是一项针对头颈部癌症患者的物理治疗计划，这些患者已经接受了颈部清扫术。本定性研究的目的是了解该干预措施是否有用、可接受，以及是否可行进行随机对照试验（RCT）。

设计

这项定性研究是在 GRRAND 可行性（GRRAND-F）研究中进行的。

地点

参与者是 2020 年至 2021 年期间从英格兰的四家急性 NHS 医院招募的。

参与者

我们采访了来自牛津的一个单一研究地点的四名常规护理和四名干预患者参与者。其中有 6 名男性，2 名女性。他们都是白人英国血统。我们采访了两名在牛津提供 GRRAND-F 干预的物理治疗师，以及来自伯明翰、普尔和诺维奇的物理治疗师，他们接受过提供干预的培训，但在研究时间框架内无法提供干预。

结果

分析确定了五个主题：（1）可接受性，（2）依从性，（3）结果，（4）可行性和（5）独立主题（预康复、视频咨询、医疗保健使用）。患者参与者和物理治疗师参与者都认为常规护理没有满足患者的康复需求。GRRAND 干预提供了生物心理社会支持。与常规护理组相比，接受干预的患者参与者对自己进行康复锻炼的能力更有信心，更有动力进行长期的适应性行为改变。物理治疗师认为他们需要更多的行政支持才能参加 RCT。