文化适应的RN-MD协作SICP基于ACP:在晚期癌症患者中的可行性RCT
Sayaka Takenouchi1, Yu Uneno2, Shigemi Matsumoto3
1Human Health Sciences, Graduate School of Medicine, Kyoto University (S.T., A.C., T.K., S.T.), Kyoto, Japan.
Journal of pain and symptom management
|September 5, 2024
概括
文化适应的预先护理计划改善了晚期癌症患者的精神福祉和生活质量,他们更喜欢家庭参与. 虽然完成率低于目标,但干预对未来的试验有希望.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 文化适应对于以自治为重点的项目至关重要,例如严重疾病护理计划 (SICP).
- 一些患者群体高度重视家庭参与的决策.
- 优化干预措施需要根据特定的文化背景和偏好进行调整.
研究的目的:
- 评估基于SICP的提前护理规划 (ACP) 干预措施的可行性和有效性.
- 评估一个护士-医生合作的ACP干预措施,用于更喜欢家庭参与的晚期癌症患者.
- 根据文化价值调整ACP,并加强以患者为中心的护理.
主要方法:
- 瘤护士提供了基于SICP的文化调整的ACP干预,强调建立信任和家庭参与.
- 包括在一线缓和化疗开始后六周内的患者.
- 主要终点包括70%的完成率和精神健康 (FACIT-Sp);次要终点评估了焦虑,抑郁,生活质量 (QOL) 和ACP进展.
主要成果:
- 干预组的精神健康显著改善 (P = 0.009).
- 在干预组中观察到改善生活质量 (QOL) 和预先护理计划 (ACP) 的进展.
- 六个月完成率为67.2%,低于70%的目标.
结论:
- 文化适应的ACP干预措施改善了精神福祉,质量生活和ACP进步,尽管未达到完成目标.
- 调查结果表明,应该完善干预手册,以提高可行性.
- 通过以疗效为重点的随机对照试验进行进一步的研究是有必要的.
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