INTRODUCTION:A pilot trial was carried out to determine if a focussed narrative interview could alleviate the components of suffering and anxiety and depression in advanced cancer patients. INTERVENTION:Patients recruited were invited to participate in a focussed narrative interview and reflect on their perspectives on their sense of "meaning", regarding suffering and their psychological, physical, social and spiritual well being - the emphasis was on allowing the patient to tell their story. Patients were encouraged to share what resources they themselves had utilised in addition to what professional care they may have received, to maintain a sense of well being. METHOD:Patients with advanced metastatic disease were recruited from hospices in the North West of England - the only exclusion criteria were not being able to understand written and spoken English and a non cancer diagnosis. At recruitment patients were asked to complete a numerical scale for suffering; the Brief Edinburgh Depression Scale, Edmonton Symptom Assessment Scale (ESAS), FACIT Spiritual well being questionnaire, Demographic information was collected and patients were randomised to either the intervention arm of the trial or the usual care arm of the study. Patients in both groups were invited to complete each measure at 2, 4 and 8 weeks. RESULTS:One hundred people were recruited into the study - 49 were randomised to intervention group and 51 to control group. The median age of patients was 66 years age range (31-89 years) and 68% of patients were female. At baseline the ECOG performance of 75% of patients recruited was 1 or 2. The median survival of all patients in the study was 169.5 days (range 10 days to still alive at end of study). There was no significant difference at any timepoint in scores on suffering measure between intervention group and control group. At each time point the intervention demonstrated mean improvement in scores for depression and anxiety on ESAS - the greatest changes for both depression and anxiety were seen at 4 weeks. CONCLUSION:This pilot randomised controlled trial of a focussed narrative intervention demonstrated an improvement in mean changes in scores for depression and anxiety at 2, 4, and 8 weeks. We suggest this intervention may have beneficial effects on depression and anxiety, but a larger powered trial is required to determine the full effects.

译文

引言:进行了一项试验性试验,以确定集中的叙述性访谈是否可以减轻晚期癌症患者的痛苦,焦虑和抑郁情绪。
干预措施:应邀招募患者参加专门的叙述性访谈,并反思他们对“意义”感,痛苦以及心理,身体,社会和精神健康的看法-重点是让患者说出自己的想法。故事。鼓励患者分享他们自己除了已获得的专业护理外还使用了哪些资源,以保持健康感。
方法:患有晚期转移性疾病的患者是从英格兰西北部的一家医院中招募的,唯一的排除标准是不懂英语的口语和口语,并且不能诊断出癌症。在招募时,患者被要求填写痛苦的数字量表。简要的爱丁堡抑郁量表,埃德蒙顿症状评估量表(ESAS),FACIT精神健康问卷,人口统计信息,患者被随机分配至试验的干预组或研究的常规护理组。两组患者均被邀请在第2、4和8周完成每项测量。
结果:一百人被招募到研究中-49被随机分配到干预组和51到对照组。患者的中位年龄为66岁(31-89岁),患者中68%为女性。基线时,新招募患者的75%的ECOG表现为1或2。研究中所有患者的中位生存期为169.5天(研究结束后10天内仍存活)。干预组与对照组之间在任何时间点的痛苦程度评分均无显着差异。在每个时间点,干预措施均显示出ESAS抑郁和焦虑评分的平均改善-在第4周,抑郁和焦虑的变化最大。
结论:该集中叙述性干预的试验性随机对照试验表明,在第2、4和8周抑郁和焦虑评分的平均变化有所改善。我们建议这种干预措施可能会对抑郁和焦虑产生有益的影响,但需要进行更大的有力的试验才能确定其全面的影响。

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