Hunan Cancer Hospital, Changsha, Hunan, China.
Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
JAMA Netw Open. 2024 Feb 5;7(2):e2356522. doi: 10.1001/jamanetworkopen.2023.56522.
Psychoeducational interventions (PEIs), which provide both information and emotional and psychosocial support, may address the unmet needs of the caregivers of adolescent and young adult patients with cancer.
To explore the effects of an instant messaging-delivered PEI on anxiety, depression, quality of life (QOL), and coping and determine whether the intervention reduces caregivers' unmet needs.
DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial using an intention-to-treat protocol was conducted from April 1 to September 14, 2022, in a tertiary cancer hospital in China and included caregivers of patients diagnosed with cancer at age 15 to 39 years recruited using convenience sampling.
Caregivers were allocated 1:1 using a randomized block scheme to the intervention or control group. The intervention group received a 5-week PEI and usual care, whereas the control group received only usual care. The PEI was delivered through articles and calls through an instant messaging application.
The primary outcomes were changes in the levels of caregivers' anxiety and depression, measured using the 7-Item Generalized Anxiety Disorder Scale and the Patient Health Questionnaire 9, respectively. The secondary outcomes were changes in the levels of caregivers' QOL, coping, and unmet needs.
Of the 160 participants, 92 (57.5%) were male; mean (SD) age was 40.27 (8.33) years. Compared with the control group, the intervention group had significantly greater reduction in severity of anxiety (B = -3.231; 95% CI, -4.746 to -1.716; P < .001) and depression (B = -3.253; 95% CI, -5.052 to -1.454; P < .001), smaller reduction in QOL (B = 13.574; 95% CI, 0.488-26.661; P = .04), and greater reduction in unmet needs (B = -12.136; 95% CI, -18.307 to -5.965; P < .001) after the intervention. Twelve weeks after baseline, the intervention group demonstrated a significantly greater reduction only in severity of anxiety (B = -1.890; 95% CI, -3.382 to -0.397; P = .01).
In this randomized clinical trial of a mobile instant messaging-delivered PEI, caregivers' unmet needs, anxiety, and depression decreased significantly and QOL declined at a significantly slower rate immediately after the intervention in the intervention group compared with the control group. A sustained effect on anxiety was observed 12 weeks after baseline.
Chinese Clinical Trial Registry identifier: ChiCTR2200055951.
心理教育干预（PEI）提供信息和情感及心理社会支持，可能满足青少年和年轻成年癌症患者照顾者的未满足需求。
探索即时通讯传递的 PEI 对焦虑、抑郁、生活质量（QOL）和应对方式的影响，并确定该干预是否降低了照顾者的未满足需求。
设计、地点和参与者：这是一项随机临床试验，采用意向治疗方案，于 2022 年 4 月 1 日至 9 月 14 日在中国一家三级癌症医院进行，纳入了通过便利抽样招募的年龄在 15 至 39 岁间被诊断患有癌症的患者的照顾者。
照顾者按照随机分组方案 1:1 分配到干预组或对照组。干预组接受 5 周的 PEI 和常规护理，而对照组仅接受常规护理。PEI 通过即时通讯应用程序中的文章和电话提供。
主要结局是照顾者焦虑和抑郁程度的变化，分别使用 7 项广泛性焦虑障碍量表和患者健康问卷 9 进行评估。次要结局是照顾者的 QOL、应对方式和未满足需求的变化。
在 160 名参与者中，92 名（57.5%）为男性；平均（SD）年龄为 40.27（8.33）岁。与对照组相比，干预组的焦虑严重程度（B = -3.231；95%CI，-4.746 至 -1.716；P < .001）和抑郁严重程度（B = -3.253；95%CI，-5.052 至 -1.454；P < .001）显著降低，QOL 显著降低（B = 13.574；95%CI，0.488-26.661；P = .04），未满足需求显著降低（B = -12.136；95%CI，-18.307 至 -5.965；P < .001）。在基线后 12 周，干预组仅在焦虑严重程度方面表现出显著降低（B = -1.890；95%CI，-3.382 至 -0.397；P = .01）。
在这项关于移动即时通讯传递的 PEI 的随机临床试验中，与对照组相比，干预组的未满足需求、焦虑和抑郁在干预后立即显著降低，QOL 下降速度明显较慢。在基线后 12 周观察到对焦虑的持续影响。
中国临床试验注册中心标识符：ChiCTR2200055951。
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