一个连续的多重分配随机试验,用于治疗期间癌症幸存者及其非正式护理人员的症状管理
Terry Badger1, Chris Segrin2, Tracy E Crane3
1College of Nursing, University of Arizona, 1305 N. Martin Avenue, Tucson, AZ, 85721, USA. tbadger@arizona.edu.
概括
单独的症状管理和生存手册 (SMSH) 可能比SMSH加上电话咨询更有效地改善癌症幸存者的焦虑. 较低强度的SMSH可能会使大多数幸存者及其照顾者受益.
科学领域:
- 在瘤学瘤学.
- 心理学 心理学 心理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 癌症幸存者和他们的非正式照顾者在治疗期间经常经历多种症状.
- 有效的症状管理干预措施对于改善癌症幸存者的生活质量至关重要.
研究的目的:
- 为了比较两种基于证据的干预措施在癌症幸存者和他们的护理人员的症状管理中的相对有效性和最佳顺序.
- 评估针对个性化的症状管理的动态治疗方案 (DTR).
主要方法:
- 一个连续的多重分配随机试验 (SMART) 涉及癌症幸存者-护理人员二元.
- 最初的随机化为症状管理和生存手册 (SMSH) 或SMSH加电话人际辅导 (TIPC).
- 对非响应者进行重新随机化,以评估持续的SMSH或SMSH + TIPC,比较三个DTR.
主要成果:
- 最初随机选择仅接受SMSH的幸存者报告说,与接受SMSH+TIPC的人相比,他们的焦虑程度明显降低.
- 与SMSH + TIPC从第1周的DTR (DTR2) 相比,在SMSH-only DTR (DTR1) 中,幸存者的焦虑在第13周显著降低.
- 探索性分析表明,增加TIPC对高基线症状的非响应者的护理人员的潜在好处.
结论:
- 在第17周,SMSH + TIPC组合并没有比单独使用SMSH更好的症状结果.
- 较低强度的SMSH似乎是改善大多数癌症幸存者及其照顾者的抑郁和焦虑症状的潜在有效策略.
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