Web-based collaborative care intervention to manage cancer-related symptoms in the palliative care setting.

Autor:	Steel, Jennifer L., Geller, David A., Kim, Kevin H., Butterfield, Lisa H., Spring, Michael, Grady, Jonathan, Sun, Weiing, Marsh, Wallis, Antoni, Michael, Dew, Mary Amanda, Helgeson, Vicki, Schulz, Richard, Tsung, Allan
Předmět:	CANCER research DISEASES TUMORS PALLIATIVE treatment THERAPEUTICS CHRONIC pain treatment PREVENTION of mental depression MENTAL depression FATIGUE prevention TUMOR treatment FATIGUE (Physiology) TUMORS & psychology CHRONIC pain ANALYSIS of variance PSYCHOLOGY of caregivers CHI-squared test COMPARATIVE studies COOPERATIVENESS INTERNET RESEARCH methodology MEDICAL cooperation COMPUTERS in medicine QUALITY of life REGRESSION analysis RESEARCH RESEARCH funding RISK assessment DISEASE management EVALUATION research RANDOMIZED controlled trials TREATMENT effectiveness EVALUATION of human services programs PREVENTION
Zdroj:	Cancer (0008543X); Apr2016, Vol. 122 Issue 8, p1270-1282, 13p
Abstrakt:	Background: The aim of this study was to examine the efficacy of a collaborative care intervention in reducing depression, pain, and fatigue and improve quality of life.Methods: A total of 261 patients with advanced cancer and 179 family caregivers were randomized to a web-based collaborative care intervention or enhanced usual care. The intervention included the following: 1) a web site with written and audiovisual self-management strategies, a bulletin board, and other resources; 2) visits with a care coordinator during a physician's appointment every 2 months; and 3) telephone follow-up every 2 weeks. Primary patient outcomes included measures of depression, pain, fatigue, and health-related quality of life. Secondary outcomes included Interleukin (IL)-1α, IL-1β, IL-6, and IL-8 levels, Natural Killer (NK) cell numbers, and caregiver stress and depression.Results: At the baseline, 51% of the patients reported 1 or more symptoms in the clinical range. For patients who presented with clinical levels of symptoms and were randomized to the intervention, reductions in depression (Cohen's d = 0.71), pain (Cohen's d = 0.62), and fatigue (Cohen's d = 0.26) and improvements in quality of life (Cohen's d = 0.99) were observed when compared to those in the enhanced usual car arm at 6 months. Reductions in IL-6 (φ = 0.18), IL-1β (φ = 0.35), IL-1α (φ = 0.19), and IL-8 (φ = 0.15) and increases in NK cell numbers (φ = 0.23) were observed in comparison with enhanced usual care arm at 6 months. Reductions in caregiver stress (Cohen's d = 0.75) and depression (Cohen's d = 0.37) were observed at 6 months for caregivers whose loved ones were randomized to the intervention arm.Conclusions: The integration of screening and symptom management into cancer care is recommended. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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