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促进干细胞移植后医疗依从性的干预措施开发

Intervention Development to Promote Medical Adherence After Stem Cell Transplant.

作者信息

Posluszny Donna M, Nezu Arthur M, Bovbjerg Dana H, Syrjala Karen L, Dew Mary Amanda

机构信息

University of Pittsburgh, Pittsburgh, USA.

UPMC Hillman Cancer Center, Pittsburgh, USA.

出版信息

J Clin Psychol Med Settings. 2025 Apr 26. doi: 10.1007/s10880-025-10078-0.


DOI:10.1007/s10880-025-10078-0
PMID:40281324
Abstract

Allogeneic hematopoietic cell transplantation (HCT) can be a lifesaving treatment for patients with hematologic disease. However, adherence to the post-HCT clinical regimen has many challenges that patients and their family caregivers must manage after hospital discharge. To address their needs, we developed a Dyadic Problem-Solving Therapy (DPST) intervention, then examined its feasibility and acceptability to patients and their family caregivers. Twelve patient-family caregiver dyads participated. Four dyads received DPST in person, four received it via online video conferencing. Another four received an enhanced usual care (EUC) intervention of the same length. Feasibility was assessed using completion rates, while acceptability was assessed using satisfaction ratings on the Client Satisfaction Questionnaire. DPST and EUC were both feasible (100% of dyads who started the intervention completed it) and acceptable with satisfaction ratings ranging from 3.6 to 4 for patients and 3.6-3.9 for family caregivers on a 1-4 scale for both DPST groups and ranging from 3.3 to 3.8 for EUC patients and 3.5-4 for EUC family caregivers. There were no evident differences by mode of intervention delivery. DPST, both in person and via video, appears feasible and acceptable for training patient-family caregiver dyads to manage challenges to adherence to the post-HCT regimen.

摘要

异基因造血细胞移植(HCT)对血液病患者而言可能是一种挽救生命的治疗方法。然而,在出院后,患者及其家庭照护者必须应对诸多挑战以坚持HCT后的临床治疗方案。为满足他们的需求,我们开发了一种二元问题解决疗法(DPST)干预措施,随后检验了其对患者及其家庭照护者的可行性和可接受性。12对患者 - 家庭照护者参与其中。4对接受了面对面的DPST,4对通过在线视频会议接受了该疗法。另外4对接受了时长相同的强化常规护理(EUC)干预。使用完成率评估可行性,使用《客户满意度调查问卷》中的满意度评分评估可接受性。DPST和EUC均可行(开始干预的二元组中有100%完成了干预),且可接受,DPST组患者的满意度评分在1 - 4分制中为3.6至4分,家庭照护者为3.6 - 3.9分;EUC患者的满意度评分在3.3至3.8分之间,EUC家庭照护者为3.5 - 4分。干预实施方式上没有明显差异。无论是面对面还是通过视频方式进行的DPST,对于培训患者 - 家庭照护者二元组应对坚持HCT后治疗方案所面临的挑战而言,似乎都是可行且可接受的。

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Intervention Development to Promote Medical Adherence After Stem Cell Transplant.

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本文引用的文献

[1]
Consolidated guidance for behavioral intervention pilot and feasibility studies.

Pilot Feasibility Stud. 2024-4-6

[2]
Medication Adherence among Allogeneic Haematopoietic Stem Cell Transplant Recipients: A Systematic Review.

Cancers (Basel). 2023-4-25

[3]
Rates and Predictors of Nonadherence to the Post-Allogeneic Hematopoietic Cell Transplantation Medical Regimen in Patients and Caregivers.

Transplant Cell Ther. 2022-3

[4]
A Prospective Survey of Outpatient Medication Adherence in Adult Allogeneic Hematopoietic Stem Cell Transplantation Patients.

Biol Blood Marrow Transplant. 2020-9

[5]
Self-management of patients with advanced cancer: A systematic review of experiences and attitudes.

Palliat Med. 2020-2

[6]
Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice.

PLoS One. 2019-8-1

[7]
Psychosocial Assessment of Candidates for Transplantation scale (PACT) and survival after allogeneic hematopoietic stem cell transplantation.

Bone Marrow Transplant. 2018-10-23

[8]
An online randomized controlled trial, with or without problem-solving treatment, for long-term cancer survivors after hematopoietic cell transplantation.

J Cancer Surviv. 2018-5-5

[9]
The Cost of Hematopoietic Stem-Cell Transplantation in the United States.

Am Health Drug Benefits. 2017-10

[10]
Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence.

PLoS One. 2017-10-17

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