Status Of Supportive Care Needs And Construction Of A Supportive WeChat Platform Program For Acute Leukemia Patients And Their Caregivers

Objectives1.To investigate the status and influence factors of supportive care needs among patients with acute leukemia,and to explore the correlation between patients’ supportive care needs and quality of life.2.To investigate the status and influence factors of supportive care needs among caregivers of patients with acute leukemia,and to explore the correlation between caregivers’ supportive care needs and quality of life.3.To explore the effects of psychoeducational interventions on quality of life,self-efficacy and negative emotion in caregivers of patients with cancer.And to analyze the theoretical framework,contents,forms,and methods of psychoeducational interventions.4.To construct a psychoeducational intervention program based on We Chat platform for acute leukemia patients and their caregivers.Methods1.By convenient sampling method,the patients with acute leukemia in three Fujian general hospitals were investigated using a self-designed status questionnaire,the 34-item Supportive Care Needs Survey,Hospital Anxiety and Depression Scale,and Functional Assessment of Cancer Therapy-Leukemia Scale from April 2017 to January 2018.The data was collected by Epidata 3.1 and analyzed by SPSS 22.0 software.Statistical analysis methods included descriptive analysis,chi-square test,multivariate logistic regression,and Spearman rank correlation analysis.2.By convenient sampling method,the caregivers of patients with acute leukemia in three Fujian general hospitals were investigated through a self-designed status questionnaire,Comprehensive Needs Assessment Tool in cancer for Caregivers,Hospital Anxiety and Depression Scale,the MOS 36-item Short-Form Health Survey from April 2017 to January 2018.The data was collected by Epidata 3.1 and analyzed by SPSS 22.0 software.Statistical analysis methods included descriptive analysis,t-test,chi-square test,multiple stepwise regression analysis,Spearman rank correlation analysis.3.The systematic review of the effects of psychoeducational interventions on self-efficacy,quality of life,and negative emotions among caregivers of patients with cancer was cinducted.Nine Chinese and English databases were searched.Two reviewers independently screened literature,extracted data,and assessed the quality of included studies.A narrative synthesis was chosen to describe the included studies.4.Based on the results of patients and their caregivers’ supportive care needs status and influence factors and systematic review,the supportive We Chat platform was initially constructed for acute leukemia patients and their caregivers.Results1.The scores of supportive care needs on 306 investigated acute leukemia patients from high to low were health system and information needs 53.41(40.91),psychological needs 42.50(37.50),physical and daily living needs 40.00(35.00),care and support needs 35.00(35.00),sexual needs 0.00(25.00).The unmet rates of 22 items were over 50%,accounting for 64.7% of the total number of entries.The results of multivariate logistic regression showed that marriage,age,job,education level,other diseases,disease course,chemotherapy course and treatment stage were the factors affecting the supportive care needs of acute leukemia patients(P<0.05).There were negative correlations between every dimensions scores of SCNS-SF34 and the total scores of quality of life in patients with acute leukemia(r =-0.170 ~-0.688,P<0.01).2.The scores of supportive care needs on 306 investigated caregivers of patients with acute leukemia patients from high to low were health-care staff needs 79.17(46.00),information needs 70.83(25.00),hospital facilities and service needs 61.11(39.00),practical support needs 55.56(33.00),psychological problems needs 44.44(33.00)cents,family/social support needs 33.33(47.00),and religious/spirit support needs 33.33(50.00).The unmet rates of 40 items were over 50%,accounting for 97.6% of the total number of entries.The results of multivariate logistic regression showed that place of residence,age,education level,religion,job,relationship with patents,time of day care,types of care,and take care of others were the factors affecting the supportive care needs of caregivers.There were negative correlations between psychological problems needs,family/social support needs and physical component summary(r=-0.366,P<0.01;r=-0.235,P<0.01)and mental component summary(r=-0.535,P<0.01;r=-0.357,P<0.01)in caregivers of patients with acute leukemia.3.The systematic literature review included 22 studies with 3523 participants.The narrative synthesis results showed that psychoeducational intervention had significantly effects on self-efficacy and quality of life among caregivers of patients with cancer,but there was no significant effect on negative emotions such as anxiety and depression.The stress-coping model and cognitive behavior theory often as the theoretical framework of psychoeducational intervention.A two-armed,1:1 groups of randomized controlled trial was designed through computer.Face-to-face,telephone and Internet intervention were the main forms.The intervention contents included education/information,coping skills,and consultation/suggestions.4.Based on the results of the first three studies,a 3-month psychoeducational intervention program was constructed according to the theoretical framework of stress-coping model,and the functions of We Chat group,video,voice chat,and public platform for the newly diagnosed acute leukemia patients and their caregivers.Conclusion1.The supportive care needs of patients with acute leukemia was in the low level.The degrees of health system and information needs,psychological needs were highest.The needs of patients were affected by many factors.The more unmet needs,the lower quality of life among patients.2.The supportive care needs on caregivers of patients with acute leukemia was in the low level.The degrees of health-care staff needs,information needs were highest.The supportive needs of caregivers were affected by many factors.The higher needs of the health and psychological program and family/social support,the lower quality of care among caregivers.3.Psychoeductional interventions through face-to-face,telephone,and internet provided education/information,coping skills,and counseling/recommendation support to cancer patients and their caregivers.It effectively improved the self-efficacy and quality of life among caregivers of patients with cancer,and provided guidance on the future intervention studies in the acute leukemia patients and their caregivers.4.The using criteria,intervention methods,evaluation systems,and backstage management norms of the supportive We Chat platform intervention program for acute leukemia patients and caregivers had been constructed initially to lay the foundation for the future studies.