| ObjectivesTo explore the feasibility and the preliminary effects of supportive care intervention for supportive care needs,psychological distress,social support and quality of life for patients with lung cancer.Combining process evaluation and qualitative feedback results of patients,the optimization strategy of intervention program to be proposed.MethodsA total of 63 cases of lung cancer patients in a third-grade a hospital in Anhui province were enrolled by convenient sampling method.To avoid potential contamination between groups,patients in the intervention group and the control group were included in stages,the the control group included 31 cases and the intervention group included 32 cases.The patients in the intervention group were given routine nursing care on the basis of the implementation of supportive care intervention program.Nursing Professional Social Support Needs Scale(NPSSNS),Psychological Distress Thermometer Thermometer(DT),Perceived Social Support Scale(PSSS)and Functional Assessment of Cancer treatment-lung(FACT-L4.0)were used to measure the two groups of patients.The time points of measurement were 4times on the day of admission,the day of postoperative discharge,the day of first chemotherapy and the day of the third chemotherapy.The overall changes of supportive care needs,needs acquired,psychological distress,social support and quality of life before and after intervention in the two groups were compared using two-way repeated measurement ANOVA.One-way repeated measurement ANOVA was used to analyze the outcome variables scores of patients in the intervention groupat different measurement points.Two independent sample t-tests were used to compare the outcome variables scores between the two groups at different time points after intervention.Through the implementation process evaluation and the qualitative feedback of patients in the intervention group after the end of the intervention for the intervention program,the improvement opinions were collected to further optimize the program.Results1.A total of 63 patients were included,including 31 in the control group and 32 in the intervention group.The patient retention rates at different time points after intervention were 100%,62% and 57%,respectively.95%(30/32)patients completed more than 4 face-to-face interventions(5 times in total),and 84%(27/32)patients completed more than 3 telephone interventions(4 times in total).Most patients reported no additional burden of intervention.2.Comparison of scores of SCNs after intervention in two groups(1)The results of repeated measures ANOVA showed that there were statistically significant differences in the total scores of SCNs and scores of each dimension for time effects(except emotional needs and care needs dimensions),interaction effects and grouping effects between the two groups(all P<0.01).The differences in time effect,interaction effect and grouping effect of the total score of SCNs acquired and scores of each dimension were statistically significant(all P<0.01).(2)Pairwise comparison of different measurement time points in the intervention group showed that the pairwise comparison differences of information needs scores at each measurement time point were statistically significant(all P<0.01),and the pairwise comparison differences of the total score of SCNs acquired and the score of lung cancer specific needs acquired at different measurement time points were statistically significant(all P<0.01).(3)In the comparison between the two groups at different measurement time points after the intervention,the total score and scores of each dimension of SCNs in theintervention group were significantly lower than those in the control group,and the total score and scores of each dimension of SCNs acquired were significantly higher than those in the control group(all P<0.05).3.Comparison of scores of DT and PSSS between the two groups(1)The results of repeated measures ANOVA showed that scores of in the two groups were affected by time effect,interaction effect and grouping effect(all P<0.01),The total score of PSSS and scores of all dimensions were affected by interaction effect and grouping effect(all P<0.01),while the difference of time effect was not statistically significant.(2)Pairwise comparison of different measurement points in the intervention group showed no statistically significant difference in DT scores at T1-T2.There was no statistically significant difference in the total score of PSSS,friends support and other support when T0-T1.Family support score in T0-T3 difference was statistically significant(P<0.01),in other every measuring point comparing two there was no statistically significant difference.(3)In the comparison between the two groups at different measurement time points after the intervention,there were no significant differences in DT and PSSS at T1,while there were statistically significant differences at T2 and T3(all P<0.05).4.Comparison of scores of FACT-L between the two groups(1)The results of repeated measures ANOVA showed that the time effect differences of family/social status scores were statistically significant(all P<0.01),There were statistically significant differences in the interaction effect and grouping effect of the total score of FACT-L and the scores of each dimension(all P<0.01).(2)pairwise comparison of different measurement points in the intervention group showed that there were no statistically significant differences in the total score of FACT-L and all dimensions(except additional attention)at T0-T1.There were no statistically significant differences in additional attention were T1-T3 and T2-T3,and the differences between other measurement points were statistically significant(allP<0.01).(3)In the comparison between the two groups at different measurement time points after the intervention,there were no significant differences in FACT-L at T1,while at T2(except additional attention),T3,the differences between the two groups were statistically significant(P<0.05),The total score of FACT-L and each dimension in intervention group significantly higher than the control group(all P<0.05).5.Qualitative feedback results: after the end of the intervention,a total of 12 patients in the intervention group completed the qualitative feedback of the intervention program.Key themes extracted include :(1)Motivation of intervention participation;(2)Adhere to the promotion factors of participating in the intervention;(3)Obstacles to adherence to intervention;(4)Suggestions for intervention programs.6.Optimal strategy of intervention program:(1)Objectification of intervention;(2)Operationalization of the instruction manual;(3)Standardization of telephone intervention;(4)Diversified evaluation methods.ConclusionSupportive care program for patients with lung cancer has certain feasibility,which can initially meet supportive care needs for patients with lung cancer from diagnosis to chemotherapy,improve the psychosocial outcome and improve the quality of life.Through the implementation of process evaluation and patient qualitative feedback,the optimal intervention strategy was proposed,laying a foundation for the sustainable application of the intervention program. |
PDF Full Text Request