目标:尽管癌症治疗取得了进展,生存率也有所提高,接受癌症治疗的青少年经常遭受社会心理困扰,负面情绪,和慢性健康问题。荒野疗法被认为是解决患有精神或行为健康问题的青少年中的心理社会问题的有希望的计划。关于它是否有益于青少年癌症治疗的研究很少。
方法:以试点研究的形式进行的计划评估使用定性和定量的措施来描述可行性,可接受性,安全,并探讨在13-17岁接受治疗或最近完成癌症治疗的青少年中,为期9天的荒野计划的影响。定量跟踪记录招聘,保留,安全,参与者满意度。PROMIS措施评估了精神和社会健康,积极的影响,疲劳,三个时间点的疼痛干扰和强度:预,post,在经历了九天的荒野之后三个月.随着时间的推移比较平均差异。定性数据收集涉及参与者观察和开放式访谈。
结果:达到了研究招生目标,招募8名青少年参与者,参与者保留率为100%。未报告严重不良事件,参与者在最后一天和三个月随访(9.5/10)时对荒野体验的满意度很高(9.25/10)。探索性数据分析显示得分朝着有利的方向发展,表明身体功能的社会心理结果得到改善,焦虑,抑郁症,疲劳,和同伴关系。从定性分析中可以看出,计划参与得到了支持:增强了自信心和同伴联系。该计划被评估为增加个人成就,支持社会互动,有强大的员工支持,利用自然环境。
结论:使用荒野计划是可行的,可接受,在这个高度脆弱的青少年癌症人群中也是安全的。参与者描述了随着参与者经历身体能力而发展的更大的自信和同伴联系,集团领导,和个人力量。需要更大规模的随机对照研究来了解这些项目是否可以改善心理社会结果。
Despite advances in cancer treatment and increased survival, adolescents in treatment for cancer often suffer from psychosocial distress, negative mood, and chronic health problems.
Wilderness therapy is considered a promising program to address psychosocial issues among adolescents with mental or behavioral health issues. There is little research on whether it may benefit adolescents in cancer treatment.
This program evaluation in the form of a pilot study uses qualitative and quantitative measures to describe the feasibility, acceptability, safety, and to explore the impact of a nine-day
wilderness program among adolescents aged 13-17 in treatment or who recently finished treatment for a cancer. Quantitative tracking documented recruitment, retention, safety, and participant satisfaction. PROMIS measures assessed mental and social health, positive affect, fatigue, pain interference and intensity over three time-points: pre, post, and three-months after the nine-day
wilderness experience. Mean differences were compared over time. Qualitative data collection involved participant observation and open-ended interviews.
Study enrollment goals were met, enrolling eight adolescent participants with 100% participant retention. No serious adverse events were reported and participants described high satisfaction (9.25/10) with the
wilderness experience on the final day and at three-months follow-up (9.5/10). Exploratory data analysis showed scores in a favorable direction indicating improved psychosocial outcomes in physical functioning, anxiety, depression, fatigue, and peer relations. From qualitative analysis it is suggested that program participation supported: increased self-confidence and peer connection. The program was evaluated as increasing personal accomplishment, supporting social interaction, having strong staff support, and capitalizing on the natural surroundings.
Use of a
wilderness program is feasible, acceptable, and safe among this highly vulnerable adolescent cancer population. Participants described greater self-confidence and peer connection which developed as participants experienced physical competency, group leadership, and personal strength. Larger randomized controlled studies are needed to learn whether these programs can improve psychosocial outcomes.