A Multimedia Self-management Intervention to Prepare Cancer Patients and Family Caregivers for Lung Surgery and Postoperative Recovery

作者：Sun Virginia^*; Raz Dan J; Ruel Nora; Chang Walter; Erhunmwunsee Loretta; Reckamp Karen; Tiep Brian; Ferrell Betty; McCorkle Ruth; Kim Jae Y

来源：Clinical Lung Cancer, 2017, 18(3): E151-E159.

DOI：10.1016/j.cllc.2017.01.010

• Activation
• Caregiver burden
• Family caregivers
• Quality of life
• Self-efficacy

This study pilot-tested a multimedia self-management intervention for lung surgery patients and family caregivers. We administered the intervention to 60 patients/ family caregivers from before surgery to 2 to 4 weeks after. Trends for improvements were observed in scores for self-efficacy, knowledge, activation, and emotional quality of life. Patient-centered models of surgical care are needed to improve quality of life and reduce undesirable health care resource use.
Background: The purpose of this study was to evaluate the feasibility and acceptability of a multimedia self-management (MSM) intervention to prepare patients and family caregivers for lung surgery. Patients and Methods: This is a quasi-experimental, 2-group, sequential enrollment pilot study of a 4-session multimedia intervention (audio/ visual + print) to enhance self-management and quality of life (QOL) for patients and family caregivers. The intervention, Preparing for Lung Surgery, begins before surgery, and continues through hospitalization and discharge, with 2 telephone support sessions after discharge. Outcomes were assessed before surgery (preintervention), at discharge, and 2 to 4 weeks postdischarge (postintervention). Patient outcomes were assessed using the Functional Assessment of Cancer Therapy-General (QOL), MD Anderson Symptom Inventory and Functional Assessment of Cancer Therapy-Pulmonary Symptom Index (symptoms), self-efficacy, surgery-related knowledge, and patient activation. Family caregiver outcomes included City of Hope-QOL-Family (QOL), Caregiver Burden Scale, and knowledge. Paired t tests were used for exploratory evaluations of score changes from pre-to postintervention. Results: Sixty participants (38 patients, 22 family caregivers) enrolled in the study (70% accrual). Postintervention scores were significantly improved for patients' emotional QOL (P = .001). Trends for improvements were observed for patient self-efficacy, surgery-related knowledge, and activation. Family caregivers' surgery-related knowledge was significantly improved (P = .02). Overall, participants were highly satisfied with the acceptability/ usability of the intervention (3.6-3.7 of 4.0). Conclusion: A standardized MSM intervention was feasible and acceptable in supporting readiness and preparedness for lung surgery and postoperative recovery. A larger randomized trial is needed to verify the impact of the MSM intervention on patient/ family caregiver outcomes and health care resource use.

• 出版日期2017-5