Department of Behavioral Science, Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA.
Psychooncology. 2024 Mar;33(3):e6316. doi: 10.1002/pon.6316.
Observational data suggest hope is associated with the quality of life and survival of people with cancer. This trial examined the feasibility, acceptability, and preliminary outcomes of "Pathways," a hope intervention for people in treatment for advanced lung cancer.
Between 2020 and 2022, we conducted a single-arm trial of Pathways among participants who were 3-12 weeks into systemic treatment. Pathways consisted of two individual sessions delivered during infusions and three phone calls in which participants discussed their values, goals, and goal strategies with a nurse or occupational therapist. Participants completed standardized measures of hope and goal interference pre- and post-intervention. Feasibility was defined as ≥60% of eligible patients enrolling, ≥70% of participants completing three or more sessions, ≥70% of participants completing post-assessments, and mean acceptability ratings ≥7 out of 10 on intervention relevance, helpfulness, and convenience. Linear regression fixed effects models with covariates modeled pre-post changes in complete case analysis and multiple imputation models.
Fifty two participants enrolled: female (59.6%), non-Hispanic White (84.6%), rural (75.0%), and with low educational attainment (51.9% high school degree or less). Except for enrollment (54%), feasibility and acceptability markers were surpassed (77% adherence, 77% retention, acceptability ratings ≥8/10). There was moderate improvement in hope and goal interference from pre-to post-intervention (d = 0.51, p < 0.05 for hope; d = -0.70, p < 0.005 for goal interference).
Strong feasibility, acceptability, and patient-reported outcome data suggest Pathways is a promising intervention to increase hope and reduce cancer-related goal interference during advanced lung cancer treatment.
观察性数据表明，希望与癌症患者的生活质量和生存相关。本试验检验了“Pathways”的可行性、可接受性和初步结果，该试验是一种针对接受晚期肺癌治疗人群的希望干预措施。
在 2020 年至 2022 年期间，我们对处于系统治疗 3-12 周的参与者进行了“Pathways”的单臂试验。Pathways 包括在输液期间进行的两次个体会议，以及三次电话会议，参与者与护士或职业治疗师讨论他们的价值观、目标和目标策略。参与者在干预前后完成了希望和目标干扰的标准化测量。可行性定义为：≥60%符合条件的患者入组、≥70%的参与者完成三个或更多疗程、≥70%的参与者完成了后测、以及干预相关性、帮助性和便利性的平均可接受性评分≥7/10。在完整案例分析和多重插补模型中，使用协变量的线性回归固定效应模型进行模型构建。
52 名参与者入组：女性（59.6%）、非西班牙裔白人（84.6%）、农村地区（75.0%）和低教育程度（51.9%高中及以下）。除了入组率（54%）外，可行性和可接受性指标均达到（77%的依从性、77%的保留率、可接受性评分≥8/10）。从干预前到干预后，希望和目标干扰均有中等程度的改善（希望：d=0.51，p<0.05；目标干扰：d=-0.70，p<0.005）。
强有力的可行性、可接受性和患者报告结果数据表明，Pathways 是一种很有前途的干预措施，可以在晚期肺癌治疗期间增加希望并减少与癌症相关的目标干扰。
