Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: A randomized controlled trial

被引:264
作者
Rummans, TA
Clark, MM
Sloan, JA
Frost, MH
Bostwick, JM
Atherton, PJ
Johnson, ME
Gamble, G
Richardson, J
Brown, P
Martensen, J
Miller, J
Piderman, K
Huschka, M
Girardi, J
Hanson, J
机构
[1] Mayo Clin, Coll Med, Dept Psychiat & Psychol, Rochester, MN 55905 USA
[2] Mayo Clin, Canc Ctr, Dept Psychiat & Psychol & Oncol, Womens Canc Program,Chaplain Serv, Rochester, MN USA
[3] Mayo Clin, Med Social Serv, Rochester, MN USA
关键词
D O I
10.1200/JCO.2006.06.209
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose The primary goal of this study was to evaluate the feasibility and effectiveness of a structured, multidisciplinary intervention targeted to maintain the overall quality of life (QOL), which is more comprehensive than psychosocial distress, of patients undergoing radiation therapy for advanced-stage cancer. Patients and Methods Radiation therapy patients with advanced cancer and an estimated 5-year survival rate of 0% to 50% were randomly assigned to either an eight-session structured multidisciplinary intervention arm or a standard care arm. The eight 90-minute sessions addressed the five domains of QOL including cognitive, physical, emotional, spiritual, and social functioning. The primary end point of maintaining overall QOL was assessed by a single-item linear analog scale (Linear Analog Scale of Assessment or modified Spitzer Uniscale). QOL was assessed at baseline, week 4 (end of multidisciplinary intervention), week 8, and week 27. Results Of the 103 participants, overall QOL at week 4 was maintained by the patients in the intervention (n = 49), whereas QOL at week 4 significantly decreased for patients in the control group (n = 54). This change reflected a 3-point increase from baseline in the intervention group and a 9-point decrease from baseline in the control group (P = .009). Intervention participants maintained their QOL, and controls gradually returned to baseline by the end of the 6-month follow-up period. Conclusion Although intervention participants maintained and actually improved their QOL during radiation therapy, control participants experienced a significant decrease in their QOL. Thus, a structured multidisciplinary intervention can help maintain or even improve QOL in patients with advanced cancer who are undergoing cancer treatment.
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收藏
页码:635 / 642
页数:8
相关论文
共 66 条
[1]  
AARONSON NK, 1991, CANCER, V67, P839, DOI 10.1002/1097-0142(19910201)67:3+<839::AID-CNCR2820671415>3.0.CO
[2]  
2-0
[3]   Enhancing treatment fidelity in health behavior change studies: Best practices and recommendations from the NIH behavior change consortium [J].
Bellg, AJ ;
Borrelli, B ;
Resnick, B ;
Hecht, J ;
Minicucci, DS ;
Ory, M ;
Ogedegbe, G ;
Orwig, D ;
Ernst, D ;
Czajkowski, S .
HEALTH PSYCHOLOGY, 2004, 23 (05) :443-451
[4]   Improving the quality and quantity of life among patients with cancer: A review of the effectiveness of group psychotherapy [J].
Blake-Mortimer, J ;
Gore-Felton, C ;
Kimerling, R ;
Turner-Cobb, JM ;
Spiegel, D .
EUROPEAN JOURNAL OF CANCER, 1999, 35 (11) :1581-1586
[5]  
Brady MJ, 1999, PSYCHO-ONCOLOGY, V8, P417, DOI 10.1002/(SICI)1099-1611(199909/10)8:5<417::AID-PON398>3.3.CO
[6]  
2-W
[7]   Spirituality and meaning in supportive care: spirituality- and meaning-centered group psychotherapy interventions in advanced cancer [J].
Breitbart, W .
SUPPORTIVE CARE IN CANCER, 2002, 10 (04) :272-280
[8]   Quality of life in hospice patients -: A pilot study [J].
Bretscher, M ;
Rummans, T ;
Sloan, J ;
Kaur, J ;
Bartlett, A ;
Borkenhagen, L ;
Loprinzi, C .
PSYCHOSOMATICS, 1999, 40 (04) :309-313
[9]   Efficacy and medical cost offset of psychosocial interventions in cancer care: Making the case for economic analyses [J].
Carlson, LE ;
Bultz, BD .
PSYCHO-ONCOLOGY, 2004, 13 (12) :837-849
[10]  
Cella D F, 1992, J Palliat Care, V8, P8