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A Multimedia Self-management Intervention to Prepare Cancer Patients and Family Caregivers for Lung Surgery and Postoperative Recovery
Authors:Virginia Sun  Dan J. Raz  Nora Ruel  Walter Chang  Loretta Erhunmwunsee  Karen Reckamp  Brian Tiep  Betty Ferrell  Ruth McCorkle  Jae Y. Kim
Affiliation:1. Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA;2. Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA;3. Biostatistics Core, Department of Information Sciences, City of Hope, Duarte, CA;4. Department of Anesthesiology, City of Hope, Duarte, CA;5. Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA;6. Department of Respiratory Diseases and Pulmonary Rehabilitation, City of Hope, Duarte, CA;7. School of Nursing, Yale University, West Haven, CT
Abstract:

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.
Keywords:Activation  Caregiver burden  Family caregivers  Quality of life  Self-efficacy
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