CarersCanADAPT:针对患有焦虑症和抑郁症的癌症照护者的在线认知行为疗法 (iCBT) 程序的阶梯式照护路径和混合型 1 类有效性实施试验的研究方案。

IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Contemporary clinical trials Pub Date : 2024-11-17 DOI:10.1016/j.cct.2024.107749
Rebekah Laidsaar-Powell, Sarah Giunta, Lisa Beatty, Phyllis Butow, Daniel Costa, Aaron Lam, Ilona Juraskova, Olivia Cook, Fiona Crawford-Williams, Nicole M Rankin, Joanne Shaw
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This paper describes the protocol of two linked studies: Study 1a, a distress screening and stepped care pathway feasibility study and Study 1b, a hybrid implementation-effectiveness Randomised Controlled Trial (RCT) to assess the benefit of a comprehensive, carer-centred online Cognitive Behavioural Therapy (iCBT) program for carers with anxiety and depression.</p><p><strong>Methods: </strong>For Study 1a, 300 cancer carers will be screened for distress. Carers with low distress will be referred to publicly available carer resources. Carers scoring 4 and higher on the distress thermometer will complete depression and anxiety measures. Carers with high anxiety/depression will be recommended psychological therapy. Carers with mild/moderate anxiety and/or depression will be allocated to the Carers iCBT Program, evaluated via a RCT with waitlist control group (Study 1b). For Study 1b, intervention group carers will receive access to a 6-lesson self-directed online iCBT program. 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引用次数: 0

摘要

背景:癌症患者的家人或朋友照护者报告了高水平的抑郁、焦虑、照护压力和未满足的需求。在癌症照护者中,用于识别和管理痛苦的策略十分有限。本文介绍了两项关联研究的方案:研究 1a 是一项困扰筛查和阶梯式护理路径可行性研究,研究 1b 是一项混合实施效果随机对照试验 (RCT),旨在评估以护理者为中心的综合在线认知行为疗法 (iCBT) 项目对焦虑和抑郁护理者的益处:在研究 1a 中,将对 300 名癌症照护者进行压力筛查。痛苦程度较低的照护者将被转介到可公开获取的照护者资源。照护者在痛苦温度计上得分 4 分及以上者将完成抑郁和焦虑测量。焦虑/抑郁程度较高的照护者将被推荐接受心理治疗。轻度/中度焦虑和/或抑郁的照护者将被分配到照护者 iCBT 计划中,该计划将通过 RCT 与候补对照组(研究 1b)进行评估。在研究 1b 中,干预组的照护者将获得 6 课时的自主在线 iCBT 课程。候补对照组将在 14 周后接受干预。干预组和对照组将完成基线、6 周和 14 周的自我报告测量;对照组将在 20 周和 28 周完成额外的测量。iCBT RCT 的样本量需要达到 n = 88:如果该路径和 iCBT 干预是可接受的、可行的和有效的,则可提供一种可持续的、可扩展的和低成本的方法来识别和管理照护者的痛苦,并有可能改善患者和照护者的预后:试验注册:澳大利亚和新西兰临床试验注册号:ACTRN12623001341617p.
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CarersCanADAPT: Study protocol of a stepped care pathway and hybrid type 1 effectiveness-implementation trial of an online cognitive behavioural therapy (iCBT) program for cancer carers with anxiety and depression.

Background: Family or friend carers of people with cancer report high levels of depression, anxiety, caregiving strain, and unmet needs. Limited strategies for identification and management of distress have been established among cancer carers. This paper describes the protocol of two linked studies: Study 1a, a distress screening and stepped care pathway feasibility study and Study 1b, a hybrid implementation-effectiveness Randomised Controlled Trial (RCT) to assess the benefit of a comprehensive, carer-centred online Cognitive Behavioural Therapy (iCBT) program for carers with anxiety and depression.

Methods: For Study 1a, 300 cancer carers will be screened for distress. Carers with low distress will be referred to publicly available carer resources. Carers scoring 4 and higher on the distress thermometer will complete depression and anxiety measures. Carers with high anxiety/depression will be recommended psychological therapy. Carers with mild/moderate anxiety and/or depression will be allocated to the Carers iCBT Program, evaluated via a RCT with waitlist control group (Study 1b). For Study 1b, intervention group carers will receive access to a 6-lesson self-directed online iCBT program. Waitlist-controls will access the intervention at 14 weeks. Intervention and control groups will complete baseline, 6 week, and 14 week self-report measures; controls will complete additional measures at 20 and 28 weeks. A sample size of n = 88 carers in the iCBT RCT is needed.

Conclusions: If acceptable, feasible and effective, this pathway and iCBT intervention could offer a sustainable, scalable and low-cost approach to identifying and managing distress in carers, and potentially improving patient and carer outcomes.

Trial registration: Australian and New Zealand Clinical Trial Registry number: ACTRN12623001341617p.

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来源期刊
CiteScore
3.70
自引率
4.50%
发文量
281
审稿时长
44 days
期刊介绍: Contemporary Clinical Trials is an international peer reviewed journal that publishes manuscripts pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from disciplines including medicine, biostatistics, epidemiology, computer science, management science, behavioural science, pharmaceutical science, and bioethics. Full-length papers and short communications not exceeding 1,500 words, as well as systemic reviews of clinical trials and methodologies will be published. Perspectives/commentaries on current issues and the impact of clinical trials on the practice of medicine and health policy are also welcome.
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