Development Of A Supportive Care Intervention For Caregivers Of Patients With Lung Cancer

ObjectivesTo develop a supportive care intervention for caregivers of patients with lung cancer based on the supportive care needs.Literature analysis was used to describe the supportive care needs of lung cancer caregivers and the influencing factors,and the current status of supportive care intervention studies for caregivers of patients with lung cancer was summarized to provide a basis for the formulation of the intervention.Structured interview was used to collect the suggestions of caregivers on the revision for the intervention content.Expert meeting was held to collect experts' opinions on the intervention.Methods1.Literature analysis: The databases including CNKI,VIP,Wan Fang,CBM,Pub Med,Web of science,Embase,The Cochrane Library and CINAHL Complete were searched systematically for studies on supportive care intervention for caregivers of patients with lung cancer.Then the literatures were screened,evaluated,included and analyzed.Combined with the survey results on the supportive care needs of caregivers of patients with lung cancer by our research team and the results of literature analysis,the protocol of the intervention and auxiliary tools for caregivers were developed.2.Structured interview: Convenience sampling method were used in a hospital in Hefei,and 30 caregivers of patients with lung cancer were included.Considering their suggestions on the contents of the intervention,the revision of supportive care intervention and auxiliary tools for nurses were formed.3.Expert meeting: Experts in psychology and behavior research,evidence-based nursing research and clinical related departments were selected.Further revise of the intervention and intervention auxiliary tools were made according to the expert meeting results,and the final draft of the intervention were formed.Results1.Literature analysis: 358 literatures were searched,and 12 literatures were included for analysis finally.(1)Literature type: two intervention protocols,six randomized controlled trials,four quasi-experiments;(2)Time span: 2007-2018;(3)Country distribution: ten foreign studies and two Chinese studies;(4)Intervention methods:(1)intervention contents: mostly were psychological education and coping skills training;(2)intervenors: mainly nurses as the leading;(3)intervention form: mainly for face-to-face and telephone;(4)intervention follow-up time: the shortest: one month,the longest: to the death of the patient,the most common: three months(12 weeks)(5)intervention effect: supportive care can improve the level of self-efficacy of caregivers of patients with lung cancer,and the intervention effect of other outcomes has not been determined.Combined with the results of literature analysis and the preliminary survey of the research team,the protocol of the intervention and auxiliary tools for caregivers were developed.2.Structured interview: 30 caregivers of patients with lung cancer put forward a total of nine suggestions for deletion and twelve suggestions for addition.Based on professional knowledge,clinical practice and preliminary investigation,the intervention was revised as follows:(1)two items of information related to fiberoptic bronchoscopy were deleted;(2)refine the contents of a breathing exercise;(3)add a diet(stimulating food)related information introduction.According to the contents of the revised intervention,intervention auxiliary tools for nurses were formed.3.Expert meeting: Seven experts were included in the expert meeting,and the expert authority coefficient was 0.84.Experts' opinions on the intervention mainly include:(1)detailing the members of the intervention implementation team;(2)adding the form of internet intervention as a supplement;(3)refining the intervention period in combination with the treatment stage;(4)including caregivers and implementing interventions in combination with clinical pathways.After adopting expert opinions,the intervention and auxiliary tools were further revised,and the final draft of theintervention were formed.ConclusionBased on the preliminary survey of our research team,guided by the theoretical framework of supportive care and the theory of “Timing It Right”,combined with the methods of literature analysis,structured interview and expert meeting,we developed the supportive care intervention for the caregivers of patients with lung cancer,including the intervention implementation process and auxiliary tools.The process of developing the intervention was systematic,the method was scientific,the intervention was targeted,applicability and maneuverability.A feasibility study will be carried out in the future to improve the intervention by combining process evaluation feedback and feasibility optimization strategy.