Pragmatic randomised controlled trial of a personalised intervention for carers of people requiring home oxygen therapy

被引：2

作者：

Frith, Peter ^{[1
,2
]}

Sladek, Ruth ^{[1
,3
]}

Woodman, Richard ^{[4
]}

Effing, Tanja ^{[1
,5
]}

Bradley, Sandra ^{[6
]}

van Asten, Suzanne ^{[7
]}

Jones, Tina ^{[8
]}

Hnin, Khin ^{[9
,10
]}

Luszcz, Mary ^{[11
]}

Cafarella, Paul ^{[1
,5
]}

Eckermann, Simon ^{[12
]}

Rowett, Debra ^{[13
,14
]}

Phillips, Paddy A. ^{[1
,8
]}

机构：

[1] Flinders Univ S Australia, Coll Med & Publ Hlth, Adelaide, SA, Australia

[2] Univ South Australia, Hlth & Alliance Res Exercise Nutr & Act ARENA, Sch Hlth Sci, Sansom Inst Hlth Res, Adelaide, SA, Australia

[3] Flinders Univ S Australia, Coll Med & Publ Hlth, Prideaux Ctr Res Hlth Profess Educ, Adelaide, SA, Australia

[4] Flinders Univ S Australia, Coll Med & Publ Hlth, Flinders Ctr Epidemiol & Biostat, Adelaide, SA, Australia

[5] Southern Adelaide Local Hlth Network, Dept Resp & Sleep Med, Adelaide, SA, Australia

[6] Flinders Univ S Australia, Coll Nursing & Hlth Sci, Adelaide, SA, Australia

[7] Vrije Univ Amsterdam Med Ctr, Dept Internal Med, Amsterdam, Netherlands

[8] SA Hlth, Dept Hlth & Well Being, Adelaide, SA, Australia

[9] Southern Adelaide Local Hlth Network, Adelaide Sleep Hlth, Adelaide, SA, Australia

[10] Flinders Univ S Australia, Adelaide Inst Sleep Hlth, Coll Med & Publ Hlth, Adelaide, SA, Australia

[11] Flinders Univ S Australia, Dept Psychol, Coll Educ Psychol & Social Work, Adelaide, SA, Australia

[12] Univ Wollongong, Australian Hlth Serv Res Inst, Wollongong, NSW, Australia

[13] Southern Adelaide Local Hlth Network, Drug & Therapeut Informat Serv, Adelaide, SA, Australia

[14] Univ South Australia, Sch Pharm & Med Sci, Adelaide, SA, Australia

来源：

CHRONIC RESPIRATORY DISEASE | 2020年 / 17卷

基金：

澳大利亚国家健康与医学研究理事会;

关键词：

Chronic disease; caregivers; education; behavioural research; oxygen; SOCIAL SUPPORT; PERCEPTIONS; MANAGEMENT; HEALTH; LIFE; COPD;

D O I：

10.1177/1479973119897277

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

We used a pragmatic randomised controlled trial to evaluate a behavioural change strategy targeting carers of chronically hypoxaemic patients using long-term home oxygen therapy. Intervention group carers participated in personalised educational sessions focusing on motivating carers to take actions to assist patients. All patients received usual care. Effectiveness was measured through a composite event of patient survival to hospitalisation, residential care admission or death to 12 months. Secondary outcomes at baseline, 3, 6 and 12 months included carer and patient emotional and physical well-being. No difference between intervention (n = 100) and control (n = 97) patients was found for the composite outcome (hazard ratio (HR) 1.22, 95% confidence interval (CI) = 0.89, 1.68; p = 0.22). Improved fatigue, mastery, vitality and general health occurred in intervention group patients (all p values < 0.05). No benefits were seen in carer outcomes. Mortality was significantly higher in intervention patients (HR = 2.01, 95% CI = 1.00, 4.14; p = 0.05; adjusted for Australia-modified Karnofsky Performance Status), with a significant diagnosis-intervention interaction (p = 0.028) showing higher mortality in patients with COPD (HR 4.26; 95% CI = 1.60, 11.35) but not those with interstitial lung disease (HR 0.83; 95% CI = 0.28, 2.46). No difference was detected in the primary outcome, but patient mortality was higher when carers had received the intervention, especially in the most disabled patients. Trials examining behavioural change interventions in severe disease should stratify for functionality, and both risks and benefits should be independently monitored.

引用

页数：11

共 35 条

[1]

Abernethy Amy P, 2005, BMC Palliat Care, V4, P7

[2] Delivery Strategies to Optimize Resource Utilization and Performance Status for Patients With Advanced Life-Limiting Illness: Results From the "Palliative Care Trial" [ISRCTN 81117481] [J].