探索与患者相关的背景因素和个人对阿尔伯塔南部大都市和非大都市晚期癌症成人管理癌症和有意义生活(CALM)干预的反思:一项混合方法研究。

IF 3.3 2区 医学 Q2 ONCOLOGY Psycho‐Oncology Pub Date : 2025-01-01 DOI:10.1002/pon.70067
Carly Sears, Fay Strohschein, Scott Patten, Andrea Feldstain, Jessica Simon, Janet de Groot
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引用次数: 0

摘要

背景:基于证据的管理癌症和有意义的生活(CALM)心理治疗干预旨在解决晚期癌症患者的复杂需求。充足的证据支持CALM疗法的有效性;对影响镇静治疗开始和持续的患者特异性因素了解较少。目的:了解影响镇静开始和持续的患者特异性因素和转诊途径。方法:使用解释性描述框架和并发三角测量混合方法设计分析基线患者特定变量,以预测从加拿大南阿尔伯塔省的癌症中心、姑息治疗服务和社区癌症护理组织招募患者后,CALM的参与度(会话数)。患者输入(n = 10)通过半结构化访谈进行,探讨晚期癌症的经历、CALM转诊和参与。结果:在同意的个体(n = 69)中,由医疗保健提供者(HCPs)直接转诊和自我转诊的个体(总n = 32)比间接转诊的个体(M = 3.19, SD = 2.26, p 10个月)参与更多的CALM会话(M = 4.97, SD = 3.51)。参与者选择CALM是基于痛苦的经历,想要公开交谈,并期望获益。结论:在hcp直接转诊后,更多的患者参与CALM干预可能是基于对hcp -患者关系的信任,并准确预测足够的身体健康状况,以参与和受益。未来的卫生系统研究可能会评估系统规划,在晚期癌症诊断后提供CALM转诊。
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Exploring Patient-Related Contextual Factors and Personal Reflections About the Managing Cancer and Living Meaningfully (CALM) Intervention for Adults With Advanced Cancer in Metropolitan and Non-Metropolitan Southern Alberta: A Mixed Methods Study.

Background: The evidence-based Managing Cancer and Living Meaningfully (CALM) psychotherapeutic intervention was designed to address the complex needs of those with advanced cancer. Ample evidence supports the efficacy of CALM therapy; less is known about the patient-specific factors that influence initiation and continuation of CALM sessions.

Aims: To gain understanding of patient-specific factors and referral routes that influence initiation and continuation of CALM.

Methods: An Interpretive Description framework and concurrent triangulation mixed-methods design was used to analyse baseline patient-specific variables for prediction of engagement (number of sessions) in CALM following recruitment from cancer centres, palliative care services, and community cancer care organisations across Southern Alberta, Canada. Patient input (n = 10) occurred through semi-structured interviews exploring experiences with advanced cancer, CALM referral and engagement.

Results: Among consented individuals (n = 69), those directly referred by healthcare providers (HCPs) and self-referred (total n = 32), engaged in more CALM sessions (M = 4.97, SD = 3.51) than those referred indirectly (M = 3.19, SD = 2.26, p < 0.05), particularly younger participants (< 65 years) and those with longer life expectancy (> 10 months). Participants chose CALM based on experiences of distress, wanting to talk openly, and expecting benefit.

Conclusions: Greater patient engagement in the CALM intervention following HCPs' direct referrals may be based on trust in the HCP-patient relationship, and accurately prognosticating sufficient physical well-being for participation and benefit. Future health systems research may evaluate systematic programing with offering CALM referrals following an advanced cancer diagnosis.

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来源期刊
Psycho‐Oncology
Psycho‐Oncology 医学-心理学
CiteScore
6.30
自引率
8.30%
发文量
220
审稿时长
3-8 weeks
期刊介绍: Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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