针对癌症青少年及其父母的预先护理计划的多中心随机对照试验：对亲子沟通的影响。

Multi-center randomized controlled trial on advance care planning for adolescents with cancer and their parents: Impact on parent-adolescent communication.

作者信息

van Driessche Anne, Cohen Joachim, Deliens Luc, Kars Marijke C, Willems Leen, De Buyser Stefanie, Verlooy Joris, Renard Marleen, Eecloo Kim, De Vleminck Aline, Beernaert Kim

机构信息

End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Aartselaar 103, 1090, Brussels, Belgium; Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium; Department of Public Health and Primary Care, Ghent University, 9000, Ghent, Belgium.

出版信息

Eur J Oncol Nurs. 2025 Apr;75:102823. doi: 10.1016/j.ejon.2025.102823. Epub 2025 Jan 29.

DOI:10.1016/j.ejon.2025.102823

PMID:39904082

Abstract

PURPOSE

This study evaluates whether the Benefits of Obtaining Ownership Systematically Together in pediatric Advance Care Planning (BOOST pACP) intervention improves parent-adolescent communication compared to care as usual.

METHODS

In this multi-center parallel-group superiority trial, adolescent patients (10-18 years old) diagnosed with cancer and their parent(s) were randomized with a 1:1 allocation to a pACP intervention or care as usual. The primary endpoint was the adolescents' assessment of quality of parent-adolescent communication at 3 months, and the secondary was quality of parent-adolescent communication at 7 months.

RESULTS

Forty-nine families were enrolled (28% enrollment rate) between March 2021 and March 2023. No significant differences in parent-adolescent communication were observed between the BOOST and care as usual groups at 3 months (T1) (baseline-adjusted mean difference = 1.4; 95% CI -4.1 to 6.9; p = 0.608), effect size 0.13. Similarly, at 7 months (T2) differences were not significant (baseline-adjusted mean difference = 5.2; 95% CI -0.6 to 11.0; p = 0.077), effect size 0.49 (and 0.67 for father-adolescent communication). No significant differences in anxiety scores of adolescents and parents were found and no adverse events were reported.

CONCLUSION

The BOOST pACP intervention did not significantly improve parent-adolescent communication for adolescents with cancer and their parents at 3 months after baseline. However, the results indicate it might have a clinical impact in later stages of the follow-up period. Limitations of this study are the underpowered sample size and the lack of validated questionnaires for specific ACP communication.

CLINICAL TRIAL REGISTRATION

ISRCTN, number 33228289 https://doi.org/10.1186/ISRCTN33228289.

摘要

目的

本研究评估在儿科预先护理计划中系统地共同获得所有权的益处（BOOST pACP）干预措施与常规护理相比，是否能改善父母与青少年之间的沟通。

方法

在这项多中心平行组优势试验中，将诊断为癌症的青少年患者（10至18岁）及其父母按1:1比例随机分配至pACP干预组或常规护理组。主要终点是青少年在3个月时对父母与青少年沟通质量的评估，次要终点是7个月时父母与青少年沟通的质量。

结果

2021年3月至2023年3月期间招募了49个家庭（招募率为28%）。在3个月（T1）时，BOOST组与常规护理组之间在父母与青少年沟通方面未观察到显著差异（基线调整后平均差异 = 1.4；95%置信区间 -4.1至6.9；p = 0.608），效应大小为0.13。同样，在7个月（T2）时差异也不显著（基线调整后平均差异 = 5.2；95%置信区间 -0.6至11.0；p = 0.077），效应大小为0.49（父母与青少年沟通为0.67）。青少年和父母的焦虑评分未发现显著差异，也未报告不良事件。