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临床实践中青少年和青年癌症患者心理社会支持方案的可行性和初步效果:回顾性观察研究。

Feasibility and preliminary effectiveness of a psychosocial support program for adolescent and young adult cancer patients in clinical practice: a retrospective observational study.

机构信息

Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan.

Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.

出版信息

Support Care Cancer. 2023 Feb 2;31(2):146. doi: 10.1007/s00520-023-07596-8.

Abstract

PURPOSE

Adolescent and young adult cancer patients (AYAs) often experience profound psychological distress, with various unmet supportive care needs that can be alleviated with appropriate screening and attention by healthcare workers. The Distress Thermometer and Problem List-Japanese version (DTPL-J) is our previously developed screening tool to facilitate individual support of AYAs. This study evaluated the feasibility and preliminary effectiveness of a psychosocial support program based on the DTPL-J for AYAs in clinical practice.

METHODS

This multicenter, retrospective, observational study included 19 of 126 wards and 9 of 75 outpatient clinics at 8 institutions in Japan. Over 200 patients were expected to participate during the eligibility period. Patients participated in a support program at least once, and approximately once a month based on the DTPL-J results. The program was evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) implementation framework.

RESULTS

The screening rate of the 361 participants was 90.3%, suggesting high feasibility. Distress Thermometer scores, the number of supportive care needs, and the rates of AYAs with high distress were significantly reduced 1 month after screening (p < 0.05), suggesting the preliminary effectiveness of the program. The program was continued at the 8 institutions as part of routine care after the study.

CONCLUSION

Analysis using the RE-AIM suggested the sufficient feasibility and preliminary effectiveness of a psychosocial support program based on the DTPL-J for AYAs.

TRIAL REGISTRATION

University Hospital Medical Information Network (UMIN CTR) UMIN000042857. Registered 25 December 2020-Retrospectively registered.

摘要

目的

青少年和年轻成人癌症患者(AYAs)常常经历深刻的心理困扰,存在各种未满足的支持性护理需求,这些需求可以通过医护人员的适当筛查和关注得到缓解。我们之前开发的用于筛查 AYAs 的工具是《 distress thermometer and problem list-japanese version(DTPL-J)》。本研究评估了基于 DTPL-J 的针对 AYA 的心理社会支持计划在临床实践中的可行性和初步效果。

方法

这项多中心、回顾性、观察性研究纳入了日本 8 家机构的 126 个病房中的 19 个和 75 个门诊中的 9 个。预计在合格期内有 200 多名患者参与。患者至少参加过一次支持计划,根据 DTPL-J 的结果,大约每月参加一次。该计划使用 RE-AIM(Reach、Effectiveness、Adoption、Implementation 和 Maintenance)实施框架进行评估。

结果

361 名参与者的筛查率为 90.3%,表明可行性高。1 个月后,DTPL-J 筛查后,心理困扰温度计评分、支持性护理需求数量以及高心理困扰 AYA 的比例均显著降低(p < 0.05),表明该计划具有初步效果。研究结束后,该计划在 8 家机构继续作为常规护理的一部分。

结论

使用 RE-AIM 进行分析表明,基于 DTPL-J 的针对 AYA 的心理社会支持计划具有足够的可行性和初步效果。

试验注册

大学医院医疗信息网络(UMIN CTR)UMIN000042857。注册日期:2020 年 12 月 25 日-回顾性注册。

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