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.
引用
收藏
页码:635 / 642
页数:8
相关论文
共 66 条
[11]  
Cella D F, 1996, Oncology (Williston Park), V10, P233
[12]   Group and individual treatment strategies for distress in cancer patients [J].
Clark, MM ;
Bostwick, JM ;
Rummans, TA .
MAYO CLINIC PROCEEDINGS, 2003, 78 (12) :1538-1543
[13]   Supportive-expressive group therapy and distress in patients with metastatic breast cancer - A randomized clinical intervention trial [J].
Classen, C ;
Butler, LD ;
Koopman, C ;
Miller, E ;
DiMiceli, S ;
Giese-Davis, J ;
Fobair, P ;
Carlson, RW ;
Kraemer, HC ;
Spiegel, D .
ARCHIVES OF GENERAL PSYCHIATRY, 2001, 58 (05) :494-501
[14]  
Classen C, 1993, BRIEF SUPPORTIVE EXP
[15]  
Cohen J., 1988, STAT POWER ANAL BEHA
[16]  
CUNNINGHAM A, 1991, SKILLS HEALING 2, P1
[17]   Health-related quality-of-life assessments and patient-physician communication - A randomized controlled trial [J].
Detmar, SB ;
Muller, MJ ;
Schornagel, JH ;
Wever, LDV ;
Aaronson, NK .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (23) :3027-3034
[18]  
Devine E C, 1995, Oncol Nurs Forum, V22, P1369
[19]   Beyond the development of health-related quality-of-life (HRQOL) measures: A checklist for evaluating HRQOL outcomes in cancer clinical trials - Does HRQOL evaluation in prostate cancer research inform clinical decision making? [J].
Efficace, F ;
Bottomley, A ;
Osoba, D ;
Gotay, C ;
Flechtner, H ;
D'haese, S ;
Zurlo, A .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (18) :3502-3511
[20]  
Erickson Pennifer, 2004, J Natl Cancer Inst Monogr, P168, DOI 10.1093/jncimonographs/lgh006