Whisenant Meagan, Weathers Shiao-Pei, Li Yisheng, Aldrich Ellen, Ownby Kristin, Thomas Jessica, Ngo-Huang An, Bruera Eduardo, Milbury Kathrin
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Neurooncol Pract. 2024 Mar 22;11(4):432-440. doi: 10.1093/nop/npae025. eCollection 2024 Aug.
Because family caregivers of patients with a high-grade glioma experience high levels of distress and feel unprepared to perform the complex caregiving tasks associated with the disease and its treatment, we pilot-tested a caregiving skills intervention that integrates hands-on caregiving with coping skill training.
In this single-arm trial, caregivers participated in a 4-session research nurse-led intervention involving simulation-based caregiving skills training at the hospital and psychoeducation delivered via videoconference. We collected measures of patients' and caregivers' psychological symptoms; caregivers' caregiving self-efficacy and role adjustment; and patients' cancer-related symptoms (MDASI) at baseline and again postintervention. We tracked feasibility data.
We approached 29 dyads of which 10 dyads (34%) consented. All patients (mean age: 60 years, 89% male) and caregivers (mean age: 58 years, 80% female, 80% spouses) completed the baseline and 7 dyads completed the follow-up assessments (attrition was related to patient's hospice transfer). Seven caregivers completed all 4 sessions and rated the program as beneficial. Paired -tests revealed a significant improvement in caregiving self-efficacy at 6 weeks postintervention ( = -3.06, = .02). Although improvements in caregiver role adjustment and patient and caregiver symptoms were not observed, no decreases in symptom burden or role adjustment were found during the follow-up period.
This novel supportive care program appears to be safe, feasible, acceptable, and perceived as useful for caregivers of patients with high-grade glioma. Based on feasibility indicators and a signal of intervention efficacy, a randomized controlled trial is warranted.
由于高级别胶质瘤患者的家庭照护者承受着高度的痛苦,且觉得没有准备好去执行与疾病及其治疗相关的复杂照护任务,我们对一项将实际照护与应对技能培训相结合的照护技能干预措施进行了试点测试。
在这项单臂试验中,照护者参加了由研究护士主导的为期4节的干预,包括在医院进行基于模拟的照护技能培训以及通过视频会议提供心理教育。我们在基线和干预后再次收集了患者和照护者心理症状的测量数据;照护者的照护自我效能感和角色调整情况;以及患者的癌症相关症状(MDASI)。我们跟踪了可行性数据。
我们联系了29对患者和照护者,其中10对(34%)同意参与。所有患者(平均年龄:60岁,89%为男性)和照护者(平均年龄:58岁,80%为女性,80%为配偶)完成了基线评估,7对完成了随访评估(失访与患者转至临终关怀有关)。7名照护者完成了全部4节课程,并认为该项目有益。配对检验显示,干预后6周照护自我效能感有显著改善(t = -3.06,P = .02)。虽然未观察到照护者角色调整以及患者和照护者症状的改善,但在随访期间未发现症状负担或角色调整有下降。
这项新颖的支持性照护项目似乎是安全、可行、可接受的,且被认为对高级别胶质瘤患者的照护者有用。基于可行性指标和干预效果的迹象,有必要进行一项随机对照试验。