| ObjectiveThis study aims to construct a family resilience intervention program for breast cancer patients based on the family resilience process model and focus on coping under the cultural background of our country,and to verify its effectiveness and feasibility.This will improve the family resilience level of Chinese breast cancer families and provide new theoretical basis and intervention methods for the psychological care of breast cancer patients.Methods1.Literature analysis: Through systematic literature review and analysis,combined with family resilience-related theories and the research foundation of the research group,a draft family resilience intervention program for breast cancer patients was formed.2.Qualitative interview: Structured interviews were conducted with patients,family members and nursing staff in a breast cancer-related department of a tertiary hospital in Anhui Province,and analyze the specific content of the intervention program from different perspectives.According to the interview results,the draft intervention program was adjusted to form the first version of the intervention program.3.Expert consultation: Seventeen experts in clinical tumor treatment,clinical tumor nursing,nursing,psychology and behavior were invited to conduct two rounds of expert consultations.Further adjustments were made based on expert opinions to form a revised version of the intervention program.4.Pilot study: A total of 60 breast cancer families were selected from a breast cancer-related department of a tertiary hospital in Anhui Province,and randomly divided into an intervention group and a control group.The control group received routine care,and the intervention group received family resilience intervention on the basis of routine care.Before the intervention and 1 week after the intervention,the family resilience,coping style,family disease burden,and social support level of the two groups of participating families were evaluated,and evaluate the intervention group’s satisfaction with the intervention program.According to the problems existing in the intervention process and the intervention effect,the intervention program has been further adjusted,and finally an intervention program for the family resilience of breast cancer patients was formed.Results1.Literature analysis: A total of 8 clinical experimental studies were included,and the research objects were families of patients with various chronic diseases.Most of the research implementers were nursing researchers.Interventions were mostly delivered in the form of multifamily group meetings,with a few studies using one-on-one face-to-face or online meetings.The intervention period was 5 weeks to 6 months,the intervention frequency was 1～2 times a week or once 2～3 weeks,the number of interventions was 3～24times,and the intervention time was 0.5～3 hours.The evaluation time was before the intervention,during the intervention,at the end of the intervention and 6 months after the end of the intervention.Intervention topics included knowledge about illness and patient care,family characteristics of illness,family communication,emotion and stress management,family problems and coping,family strengths and resources,and more.Although some studies have shown improved family resilience among study participants,uncertainty remains about the applicability of these interventions to breast cancer patients due to differences in disease populations,unclear content of interventions,and varying themes.Based on the results of literature analysis,combined with family resilience theories and the research foundation of the research group,a draft intervention program was formed.2.Qualitative interview: One-on-one structured interviews were conducted with 12 clinical nurses from breast cancer-related departments and 28 pairs of breast cancer patients and their families.Put forward opinions and suggestions in terms of intervention form,frequency and time,meeting content and sequence,feasibility of intervention plan,etc.According to the interview results and group discussion,the contents of the intervention plan were adjusted as follows:(1)Intervention format: face-to-face combined with online family conferences.(2)Meeting length: 25～30min,depending on the specific situation.(3)Public account push: Push personalized disease-related knowledge according to the needs of different patients and their families.(4)Answer questions raised by patients and their families in a timely manner.The first version of intervention program was formed.3.Expert consultation: In the two rounds of expert consultation,the positive degree of the experts were 80.95% and 100%,respectively,the authority coefficients were 0.822 and0.840,and the Kendall’s W coefficients were 0.061(P>0.05)and 0.146(P<0.01).The coefficients of variation of scientificity,validity and feasibility of the two rounds of expert consultation were all Cv<0.25.According to expert recommendations,the contents of the intervention program were adjusted as follows:(1)Conference name: Modify the names of the 1st,4th,and 6th meetings.(2)Participant recruitment: patients and their primary caregiver(first-degree relatives).(3)Intervention format: 1st face-to-face meeting,remaining5 online meetings.(4)Project introduction: Invite breast cancer treatment,nursing experts and rehabilitation patients to answer questions for the research subjects.(5)Intervention process: Briefly review the previous meeting before the meeting,and introduce topics in the form of questions or case sharing.(6)Public account push: The push content is combined with the theme of the meeting.(7)Adjust the specific content of each meeting according to expert advice.The revised version of intervention program was formed.4.Pilot study: A total of 60 pairs of breast cancer patients and their families were included in the intervention group and the control group.There was no significant difference in baseline data and scale scores between the two groups of patients and their families(P>0.05),and they were comparable.Differences in outcome indicators between the two groups were analyzed using two independent samples t-tests.Both PP and ITT analyses showed that after the intervention,the family resilience,coping style and social support level of the patients and their families in the intervention group were significantly higher than those in the control group,and the level of family disease burden was significantly lower than that in the control group(P<0.05).The paired t-test was used to compare the differences in outcome indicators before and after the intervention in each group.Both PP and ITT analyses showed that in the intervention group,the family resilience,coping styles and social support levels of patients and their families after the intervention were significantly higher than those before the intervention,and the level of disease family burden was significantly lower than that before the intervention(P<0.05).In the control group,the level of family resilience of the patients after the intervention was slightly higher than that before the intervention(P<0.05),and the level of coping style,disease family burden and social support did not change significantly compared with those before the intervention(P>0.05).The level of family resilience and social support of family members was slightly higher than that before the intervention,the level of disease family burden was slightly lower than that before the intervention(P<0.05),and the coping style did not change significantly compared with that before the intervention(P>0.05).Feasibility results showed that the enrollment rate,acceptance rate,completion rate,satisfaction rate,and compliance rate from high to low of the research subjects were 64.52%,75%,91.67%,100%,90%,3.33%,and 6.67%,respectively,which means the intervention is effective and feasible.The intervention program was adjusted as follows:(1)Intervention Format: Six online family conferences.(2)Intervention content: The content of the meeting is selected according to the actual situation of the intervention family.(3)Homework: Send homework messages to participants with example sentences or instructions.ConclusionBased on the theories of family resilience and the research foundation of the research group,this study forms a draft intervention program through literature analysis.Adjust the intervention program through qualitative interviews and expert consultation,and verify the intervention program through pilot experiments.Finally,a coping-focused family resilience intervention program for breast cancer patients was developed.The construction process of the intervention program is scientific,with good effectiveness and feasibility.It provides a practical path for clinical nurses to guide and help family members of breast cancer patients make reasonable adjustments. |
PDF Full Text Request