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多媒体化疗教育干预措施在拉丁裔人群中的适应性调整:让患者叙事为自己发声。

Adaptation of a Multimedia Chemotherapy Educational Intervention for Latinos: Letting Patient Narratives Speak for Themselves.

机构信息

Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Jimmy Fund 805A, MA, 02215, Boston, USA.

Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.

出版信息

J Cancer Educ. 2023 Aug;38(4):1353-1362. doi: 10.1007/s13187-023-02270-3. Epub 2023 Feb 11.

Abstract

This study aims to adapt a video-based, multimedia chemotherapy educational intervention to meet the needs of US Latinos with advanced gastrointestinal malignancies. A five-step hybrid adaptation process involved (1) creating a multidisciplinary team with diverse Latino subject experts, (2) appraising the parent intervention, (3) identifying key cultural considerations from a systematic literature review and semi-structured Latino patient/caregiver interviews, (4) revising the intervention, highlighting culturally relevant themes through video interviews with Latino cancer patients, and (5) target population review with responsive revisions. We developed a suite of videos, booklets, and websites available in English and Spanish, which convey the risks and benefits of common chemotherapy regimens. After revising the English materials, we translated them into Spanish using a multi-step process. The intervention centers upon conversations with 12 Latino patients about their treatment experiences; video clips highlight culturally relevant themes (personalismo, familismo, faith, communication gaps, prognostic information preferences) identified during the third adaptation step. The adapted intervention materials included a new section on coping, and one titled "how to feel the best you can feel," which reviews principles of side effect management, self-advocacy, proactive communication, and palliative care. Ten Latinos with advanced malignancies reviewed the intervention and found it to be easily understandable, relatable, and helpful. A five-step hybrid model was successful in adapting a chemotherapy educational intervention for Latinos. Incorporation of video interviews with Latino patients enabled the authentic representation of salient cultural themes. Use of authentic patient narratives can be useful for cross-cultural intervention adaptations.

摘要

本研究旨在改编基于视频的多媒体化疗教育干预措施,以满足美国晚期胃肠道恶性肿瘤拉丁裔患者的需求。采用五步混合改编过程,包括:(1)组建一个具有不同拉丁裔主题专家的多学科团队;(2)评估原始干预措施;(3)从系统文献回顾和半结构化拉丁裔患者/照顾者访谈中确定关键文化考虑因素;(4)通过与拉丁裔癌症患者进行视频访谈,修订干预措施,突出与文化相关的主题;(5)对目标人群进行审查并进行相应修订。我们开发了一系列英语和西班牙语的视频、小册子和网站,传达常见化疗方案的风险和益处。在修订英文材料后,我们使用多步翻译过程将其翻译成西班牙语。干预措施以与 12 位拉丁裔患者关于其治疗经验的对话为中心;视频剪辑突出了在第三步改编过程中确定的与文化相关的主题(个人主义、家庭主义、信仰、沟通差距、预后信息偏好)。改编后的干预措施材料包括一个关于应对的新部分,以及一个题为“如何感觉最好”的部分,其中回顾了副作用管理、自我倡导、主动沟通和姑息治疗的原则。十位晚期恶性肿瘤的拉丁裔患者审查了干预措施,发现它易于理解、相关且有帮助。五步混合模型成功地改编了针对拉丁裔的化疗教育干预措施。纳入与拉丁裔患者的视频访谈使突出文化主题的真实呈现成为可能。使用真实的患者叙述可以用于跨文化干预措施的改编。

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