Source:Current Problems in Cancer
Author(s): Li Yanwei, Fang minghui, Quan manman, Yan zhuchun, Liu dongying, Pan zhanyu
ObjectiveThis study aims to examine the effects of wellness-education (WE) intervention on the behavioral change, psychological status, performance status on patients with stage IV non-small cell lung cancer (NSCLC) undergoing icotinib hydrochloride treatment and their relationships with family caregivers.MethodsWe conducted an intervention study involving 126 individuals with confirmed activating epidermal growth factor receptor (EGFR) mutation-positive stage IV NSCLC who received Icotinib hydrochloride as first-line therapy between 01/2014 and 01/2016; their caregivers were also included in the study. For a period of 12 weeks, participants were randomly assigned into WE and control groups. The patients and family members in the WE group were provided with WE information about treatment, diet, social needs, rehabilitation, physical/mental health education, communication strategies, and patient care advice at least 3 times per week during treatment. Qualitative feedback of the participants was recorded during the intervention. Food Composition Database, the Family Environment Scale (FES) , patients/caregivers quality-of-life [Functional Assessment of Cancer Therapy–Lung (FACT-L)/Caregiver Quality of Life Index-Cancer Scale (CQOLC)], and Hospital Anxiety and Depression Scale (HADS) were measured at baseline and for 12 weeks. Data were analyzed to compare the different outcomes.ResultsOf the 126 caregivers (64 WE and 62 control), 120 completed the study. We observed significant differences between the WE group and control group with respect to low daily calorie intake (31.0% vs. 77.4%, p<0.05), smoking cessationaaa and awareness of cancer (85.48% vs. 100%, p<0.05). The WE group showed high ratings on awareness of cancer risk and benefit, as well as confidence relating to the behaviors of healthful diet and self-motivation to conduct cancer test. Family caregivers had high ratings on 30-min daily moderate physical activity (p>0.05). After 12 weeks, WE intervention had improved scores on FACT-L-EWB and CQOLC adaptation. In addition, the patients also showed improvements in HADS.ConclusionWE interventions in patients with stage IV NSCLC undergoing icotinib hydrochloride treatment and their family resulted in strong intentions to engage in health-promoting behaviors related to physical activity, Smoking cessationaaa and nutrition at the treatment period. WE intervention is a viable way to improve quality of life and HADS.Practice ImplicationsFindings from this study suggests that WE interventions in patients' family with stage IV NSCLC undergoing icotinib hydrochloride treatment are significant improvements in both HADS and QoL. These data also indicate that lung cancer disparities are unlikely to be associated with differential willingness to receive care but that Chinese may perceive financial and insurance ebarriers to treatment
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