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口头指导与基于视频的教育(VIVid)在改善接受姑息治疗的晚期头颈部癌症患者生活质量方面对印度东部家庭照顾者的比较效果:一项随机对照试验。

Comparative effectiveness of verbal instruction versus video-based education (VIVid) among family caregivers for improving the quality of life in advanced head and neck cancer patients receiving palliative care in Eastern India: a randomized controlled trial.

机构信息

Department of Public Health Dentistry, S.C.B. Dental College & Hospital, Cuttack, Odisha, 753007, India.

Pain and Palliative Unit, Acharya Harihar Post-Graduate Institute of Cancer, Cuttack, Odisha, 753007, India.

出版信息

Qual Life Res. 2023 Dec;32(12):3495-3506. doi: 10.1007/s11136-023-03484-0. Epub 2023 Aug 2.

Abstract

PURPOSE

To determine if video-based educational intervention compared to the standard verbal guidelines, provided to caregivers on home-based palliative care could enhance the quality of life (QoL) in advanced head and neck cancer (HNC) patients.

METHODS

The study employed a prospective, two-arm parallel-group, randomized controlled trial design. Investigators prepared a real-world demonstrational video of ten minutes duration regarding home-based care for family caregivers, with voice-over in Odia language (Eastern India). The contents of the video addressed the management of common problems in palliative care among HNC patients. This study included 180 participants, 90 patient & caregiver dyads randomized to interventional (video-based education) or control (verbal instruction) groups. Patients' QoL was measured at baseline and 3 weeks follow-up using EORTC QLQ C30. Data were analyzed descriptively, and the Chi-square, Mann-Whitney U, T-test, spearman correlation, and multiple hierarchical regression analyses were employed for statistical analysis, with a significance level of p < 0.05.

RESULTS

Seventy participant dyads completed the planned two assessments: baseline and at the end of 3rd week (Intervention = 37; Control = 33). The intervention group showed a significant improvement in the patient's health-related QoL, physical, emotional, and social functioning. Symptom burden reduction was observed for pain, nausea, and fatigue. A significant increase in the change in QoL with the video-based education group (VBE) compared to the verbal instruction (VI) group after adjusting for age, gender, physical functioning, and pain symptomology (adjusted R = 0.402) was noted.

CONCLUSION

VBE intervention using smart-phone may offer caregivers a viable means of enhancing self-management while improving patients' QoL within the socio-cultural challenges for home-based palliative care in India. Further research on training caregivers using digital interventions and home-based visits is recommended.

TRIAL REGISTRATION NUMBER

CTRI/2021/06/034473 [Registered on: 30/06/2021].

摘要

目的

确定与提供给家庭姑息护理照顾者的标准口头指导相比,基于视频的教育干预是否可以提高晚期头颈部癌症(HNC)患者的生活质量(QoL)。

方法

本研究采用前瞻性、双臂平行组、随机对照试验设计。研究人员制作了一个时长十分钟的有关家庭护理的现实示范视频,内容是关于印度东部奥里亚语(Odia)的语音旁白,针对 HNC 患者姑息护理中常见问题的管理。该研究纳入了 180 名参与者,90 对患者和照顾者被随机分为干预组(视频教育)或对照组(口头指导)。使用 EORTC QLQ C30 在基线和 3 周随访时测量患者的 QoL。采用描述性分析、卡方检验、Mann-Whitney U 检验、t 检验、斯皮尔曼相关分析和多元层次回归分析进行统计分析,显著性水平为 p < 0.05。

结果

70 对参与者完成了计划的两次评估:基线和第 3 周结束时(干预组=37;对照组=33)。干预组患者的健康相关 QoL、身体、情绪和社会功能均有显著改善。疼痛、恶心和疲劳症状的负担减轻。在调整年龄、性别、身体功能和疼痛症状后,与口头指导组相比,基于视频的教育组(VBE)的 QoL 变化显著增加(调整后的 R = 0.402)。

结论

在印度家庭姑息护理的社会文化挑战下,使用智能手机的 VBE 干预可能为照顾者提供一种可行的自我管理方式,同时提高患者的 QoL。建议进一步研究使用数字干预和家庭访视培训照顾者。

临床试验注册号

CTRI/2021/06/034473 [注册于:2021 年 6 月 30 日]。

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