Sato Takashi, Manaka Hiroya, Kodama Miyuki, Nieda Rina, Kawamura Yasumi, Yamamoto Mina, Genkai Yasuko, Kezuka Yumiko, Watanabe Atsuko, Kaizuka Nobuki, Ito Hiroki, Sone Hideyuki, Shirasawa Masayuki, Kusuhara Seiichiro, Kakegawa Mikiko, Nakahara Yoshiro, Fujisawa Daisuke, Sasaki Jiichiro, Naoki Katsuhiko
Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Department of Nursing, Kitasato University Hospital, Sagamihara, Japan.
Palliat Med Rep. 2025 May 8;6(1):251-262. doi: 10.1089/pmr.2025.0018. eCollection 2025.
Although early palliative care (EPC) integrated into standard cancer care improves the quality of lives of patients with cancer and their caregivers, implementation strategies for EPC programs in individual clinical settings have not been established.
This pilot randomized controlled trial explored the feasibility, acceptability, and effectiveness of nurse-led EPC using a screening-based program that focused on the individual concerns of patients with advanced lung cancer and their caregivers.
This pilot study was a parallel-group randomized controlled trial in which patients were randomly assigned (1:1) to receive either EPC using the care program or standard care alone.
SETTING/SUBJECTS: At one university hospital in Japan, 32 patients with newly diagnosed stage IV lung cancer and their 27 caregivers participated.
Feasibility was evaluated using recruitment and interview execution rates. Acceptability and effectiveness of the care program were also evaluated.
The recruitment rate was 91%. The interview execution rates were 14/14 (100%) at baseline, 11/14 (79%) at 1 month, and 12/14 (86%) at 3 months for patients, and 10/11 (91%) at baseline, 6/11 (55%) at 1 month, and 7/11 (64%) at 3 months for caregivers. At 5 months, 55% of patients in the intervention group responded that the delivered care was valuable, while 88% of caregivers in the same group answered that it was valuable. The prevalence of severe concerns in patients and caregivers in the intervention group decreased after 1 month.
This pilot randomized controlled trial revealed that EPC using a screening-based program that focused on individual concerns in patients with advanced lung cancer and their caregivers was feasible and acceptable.
尽管将早期姑息治疗（EPC）纳入标准癌症护理可提高癌症患者及其护理人员的生活质量，但尚未确立在个体临床环境中实施EPC项目的策略。
本试点随机对照试验探讨了由护士主导的EPC的可行性、可接受性和有效性，该EPC采用基于筛查的项目，聚焦于晚期肺癌患者及其护理人员的个人关切。
本试点研究为平行组随机对照试验，患者被随机分配（1:1）接受使用护理项目的EPC或仅接受标准护理。
设置/受试者：在日本的一家大学医院，32例新诊断为IV期肺癌的患者及其27名护理人员参与了研究。
使用招募率和访谈执行率评估可行性。还评估了护理项目的可接受性和有效性。
招募率为91%。患者的访谈执行率在基线时为14/14（100%），1个月时为11/14（79%），3个月时为12/14（86%）；护理人员的访谈执行率在基线时为10/11（91%），1个月时为6/11（55%），3个月时为7/11（64%）。在5个月时，干预组中55%的患者表示所提供的护理有价值，而同一组中88%的护理人员回答护理有价值。干预组患者和护理人员中严重关切的发生率在1个月后有所下降。
这项试点随机对照试验表明，采用基于筛查的项目、聚焦于晚期肺癌患者及其护理人员个人关切的EPC是可行且可接受的。
