Department of Haematology, Centre of Expertise for Cancer Survivorship, Radboud university medical centre, Nijmegen, the Netherlands.
Department of Haematology, Radboud University Medical Centre, Nijmegen, the Netherlands.
BMC Cancer. 2024 Jun 11;24(1):722. doi: 10.1186/s12885-024-12430-3.
Childhood, adolescent, and young adult (CAYA) cancer survivors, at risk for late effects, including cancer-related fatigue, cardiovascular issues, and psychosocial challenges, may benefit from interventions stimulating behaviour adjustments. Three nurse-led eHealth interventions (REVIVER) delivered via video calls and elaborating on person-centred care, cognitive behaviour therapy and/or motivational interviewing were developed. These interventions target: 1) fatigue management, 2) healthier lifestyle behaviours, and 3) self-efficacy and self-management. This study aimed to assess the feasibility and potential effectiveness of the REVIVER interventions for CAYA cancer survivors and healthcare professionals.
In a single-group mixed methods design, CAYA cancer survivors aged 16-54, more than five years post-treatment, were enrolled. Feasibility, assessed via Bowen's outcomes for feasibility studies, included acceptability, practicality, integration and implementation, demand and adherence. Qualitative data from semi-structured interviews and a focus group interview with survivors and healthcare professionals supplemented the evaluation. Paired sample t-tests assessed changes in self-reported quality of life, fatigue, lifestyle, self-management, and self-efficacy at baseline (T0), post-intervention (T1), and 6-month follow-up (T2).
The interventions and video consults were generally acceptable, practical, and successfully integrated and implemented. Success factors included the nurse consultant (i.e., communication, approach, and attitude) and the personalised approach. Barriers included sustainability concerns, technical issues, and short intervention duration. Regarding demand, 71.4%, 65.4%, and 100% of eligible CAYA cancer survivors engaged in the fatigue (N = 15), lifestyle (N = 17) and empowerment (N = 3) intervention, respectively, with 5, 5 and 2 participants interviewed, correspondingly. Low interest (demand) in the empowerment intervention (N = 3) and dropout rates of one-third for both fatigue and empowerment interventions were noted (adherence). Improvements in quality of life, fatigue (fatigue intervention), lifestyle (lifestyle intervention), self-efficacy, and self-management were evident among survivors who completed the fatigue and lifestyle interventions, with medium and large effect sizes observed immediately after the intervention and six months post-intervention.
Our study demonstrates the feasibility of nurse-led video coaching (REVIVER interventions) despite lower demand for the empowerment intervention and lower adherence to the fatigue and empowerment interventions. The medium and high effect sizes found for those who completed the interventions hold potential clinical significance for future studies investigating the effectiveness of the REVIVER interventions.
儿童期、青少年期和青年期(CAYA)癌症幸存者存在发生晚期效应的风险,包括与癌症相关的疲劳、心血管问题和心理社会挑战,他们可能受益于刺激行为调整的干预措施。开发了三种由护士主导的电子健康干预措施(REVIVER),通过视频通话提供,并详细阐述了以人为本的护理、认知行为疗法和/或动机访谈。这些干预措施针对以下三个方面:1)疲劳管理,2)更健康的生活方式行为,以及 3)自我效能和自我管理。本研究旨在评估 REVIVER 干预措施对 CAYA 癌症幸存者和医疗保健专业人员的可行性和潜在有效性。
采用单组混合方法设计,招募了年龄在 16-54 岁、治疗后超过 5 年的 CAYA 癌症幸存者。采用 Bowen 可行性研究结果评估可行性,包括可接受性、实用性、整合和实施、需求和依从性。幸存者和医疗保健专业人员的半结构化访谈和焦点小组访谈的定性数据补充了评估。采用配对样本 t 检验评估了基线(T0)、干预后(T1)和 6 个月随访(T2)时自我报告的生活质量、疲劳、生活方式、自我管理和自我效能的变化。
干预措施和视频咨询通常是可以接受的、实用的,并且成功地整合和实施。成功因素包括护士顾问(即沟通、方法和态度)和个性化方法。障碍包括可持续性问题、技术问题和干预持续时间短。关于需求,分别有 71.4%、65.4%和 100%的符合条件的 CAYA 癌症幸存者参与了疲劳(N=15)、生活方式(N=17)和赋能(N=3)干预,分别有 5、5 和 2 名参与者接受了访谈。赋能干预的兴趣(需求)较低(N=3),疲劳和赋能干预的脱落率均为三分之一(依从性)。完成疲劳和生活方式干预的幸存者的生活质量、疲劳(疲劳干预)、生活方式(生活方式干预)、自我效能和自我管理均有改善,干预后即刻和干预后 6 个月均观察到中到大的效应量。
尽管对赋能干预的需求较低,且对疲劳和赋能干预的依从性较低,但我们的研究表明,由护士主导的视频辅导(REVIVER 干预)是可行的。对于那些完成干预的人,发现了中等和高的效应量,这对未来研究调查 REVIVER 干预措施的有效性具有潜在的临床意义。