斯里兰卡口腔癌患者的早期姑息治疗
科伦坡地区三级护理医院口腔癌患者心理困扰的患病率和相关因素以及“生活状况改善干预”的有效性
这项准实验研究的目的是开发和评估斯里兰卡口腔癌患者早期姑息治疗干预的有效性。 它旨在回答的主要问题是早期姑息治疗干预是否可以改善斯里兰卡癌症患者的生活质量和心理困扰。
主要结局指标是患者的生活质量和心理困扰水平。如果有对照组:研究人员与接受标准护理的对照组进行比较,看看新型早期姑息治疗干预措施是否有助于改善主要结局。
干预组的参与者接受了早期姑息治疗方案,其中包括 6 个部分,包括:1) 提供信息,2) 解决急性和功能性问题,3) 营养护理,4) 心理支持,5) 正念治疗,6) 协调的经济补贴。 干预由首席研究员和经过培训的公共卫生护理人员进行。
研究概览
详细说明
该研究在斯里兰卡三个提供口腔癌治疗的三级医疗机构进行:科伦坡国家牙科医院的口腔颌面病房(教学);卡拉皮蒂耶科伦坡南(教学)医院的口腔颌面病房;以及国家癌症研究所 Maharagama(Apeksha 医院)的肿瘤外科病房。
参与者 研究参与者是口腔癌患者,其明确诊断已传达给患者,并且有心理困扰(用僧伽罗版痛苦温度计筛查后得分≥4);等待手术作为第一治疗方式;已婚并育有子女,其中至少包括一名能够用僧伽罗语进行良好沟通和阅读的家庭护理人员。 排除标准是,复发性口腔癌;正式的精神病学诊断;正在接受或已经接受过任何早期姑息治疗干预。 根据是否有可用的公共卫生护理人员,将他们分为 55 个对照组和 55 个病例组。
干预措施 早期姑息治疗方案由六个部分组成,由首席研究员 (PI) 和公共卫生护理官员分三场进行。
结果测量 使用僧伽罗版应激温度计评估心理困扰水平,并使用 EORTC QLQ 30 和模块 H&N 35 评估基线 (T0)、干预后 (T1)、一个月 (T1) 的生活质量水平。 T2)和三个月(T3)。
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Southern
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Galle、Southern、斯里兰卡
- Karapitiya Teaching Hospital
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Western
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Colombo、Western、斯里兰卡、0007
- National Dental Hospital
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Colombo、Western、斯里兰卡
- Apeksha Hospital
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Colombo、Western、斯里兰卡
- Colombo South (Teaching) Hospital
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参与标准
资格标准
适合学习的年龄
- 孩子
- 成人
- 年长者
接受健康志愿者
描述
纳入标准:
- 向患者传达明确的诊断结果
- 存在心理困扰(用僧伽罗版遇险温度计筛查后得分≥427)
- 等待手术作为第一治疗方式
- 已婚并有孩子,其中至少包括一名能够用僧伽罗语进行良好沟通和阅读的家庭看护人。
排除标准:
- 复发性口腔癌
- 正式的精神病学诊断
- 正在接受或已经接受任何早期姑息治疗干预。
学习计划
研究是如何设计的?
设计细节
- 主要用途:支持治疗
- 分配:非随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的:干预组接受新型早期姑息治疗方案
该小组接受了新型早期姑息治疗干预方案
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早期姑息治疗干预方案是根据英国医学研究委员会提供的复杂干预措施制定指南制定的。
针对口腔癌患者的早期姑息治疗干预措施有六个组成部分:1)提供信息,2)解决急性和功能性问题,3)营养护理,4)心理支持,5)正念治疗,6)协调经济津贴。
该方案是通过对文献综述结果和几项独立研究进行三角测量而制定的:病例对照研究;深入采访斯里兰卡肿瘤学和姑息治疗领域的专家;对口腔癌患者及其护理人员进行关键信息访谈;以及斯里兰卡国家癌症研究所 - Apeksha 医院的观察研究)。
干预方案是通过
其他名称:
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无干预:对照组
该群体仅接受卫生系统现有的标准护理,并没有通过本研究接受任何特殊干预
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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患者的生活质量
大体时间:该结果测量在四个时间点收集:登记时、提供干预方案后立即、干预后 1 个月和干预后 3 个月。
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生活质量使用欧洲癌症研究和治疗组织生活质量问卷(C30 版)僧伽罗语版 -EORTC QLQ 30 进行测量。
通过大规模多中心研究,该工具被翻译到斯里兰卡并得到验证。
该工具从三个子维度衡量生活质量——全球健康状况、功能量表和症状量表。
全球健康状况高分表示生活质量高,功能量表高分表示功能健康,症状量表高分表示问题严重
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该结果测量在四个时间点收集:登记时、提供干预方案后立即、干预后 1 个月和干预后 3 个月。
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患者的心理困扰程度
大体时间:在四个时间点收集结果测量:入组时、提供干预方案后立即、干预后一个月和三个月。
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心理困扰的程度是通过僧伽罗版痛苦温度计的平均分数来衡量的。
遇险温度计是一种超短的视觉模拟筛查工具,最初于 1998 年在美国为前列腺癌患者开发。
遇险温度计附带问题列表。
这有 35 个项目,涵盖 5 个生活领域(实践、家庭/社会、情感、精神和身体问题)。
遇险温度计和问题清单被翻译成僧伽罗语(斯里兰卡的主要语言),并跨文化地适应斯里兰卡。
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在四个时间点收集结果测量:入组时、提供干预方案后立即、干预后一个月和三个月。
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患者的生活质量与头颈状况相关
大体时间:该结果测量在四个时间点收集:登记时、提供干预方案后立即、干预后 1 个月和干预后 3 个月。
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这是使用欧洲癌症研究与治疗组织的 Head & Neck-35 模块 (H&N-35) 进行测量的。
通过大规模多中心研究,该工具被翻译到斯里兰卡并得到验证。
H&N-35 模块得分高也意味着问题水平高,这意味着生活质量低。
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该结果测量在四个时间点收集:登记时、提供干预方案后立即、干预后 1 个月和干预后 3 个月。
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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患者满意度
大体时间:这是在干预方案交付 3 个月后测量的
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使用经过验证的问卷来衡量患者对新颖干预措施的满意度。
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这是在干预方案交付 3 个月后测量的
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合作者和调查者
调查人员
- 研究主任:Irosha Perera, Doctor of Medicine、Preventive oral Health Unit, National Dental Hospital, Sri Lanka
- 研究主任:Pushpakumara Kandapola Arachchige, Doctor of Medicine、National Cancer Institute, Maharagama- Apeksha Hospital, Sri Lanka
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