文化适应对于优化以自主为中心的计划至关重要，例如严重疾病护理计划 (SICP)，特别是对于重视家庭参与决策的人群。我们的目的是评估文化适应的基于 SICP 的护士的可行性和有效性。医生协作预先护理计划 (ACP) 干预措施专为喜欢家庭参与决策的晚期癌症患者量身定制。肿瘤科护士经过广泛培训并与医生密切合作，与干预组中的患者进行了结构化讨论。基于 SICP 的文化适应性 ACP 干预辅以信任建设、家庭参与和对患者价值观的理解。主要纳入标准包括开始一线姑息化疗后六周内的患者。主要终点是 6 个月时达到 70% 的完成率并评估精神健康 (FACIT-Sp)。次要终点包括同一时间间隔的焦虑 (GAD-7)、抑郁 (PHQ-9)、生活质量 (QOL) (CoQoLo) 和 ACP 进展（ACP 参与量表）。 41 名患者 (67.2%) 完成了六个月的随访，未达到目标完成率。干预组六个月精神健康状况相对基线的最小二乘平均变化为 3.00，标准护理组为 -2.22（差异为 5.22 分；95% 置信区间为 1.38-9.06；P = 0.009）。在生活质量和 ACP 进展方面也观察到了干预措施的类似优势。尽管未达到目标完成率，但干预组表现出精神健康、生活质量和 ACP 进展的改善。我们的研究结果建议对干预手册进行修订，以提高可行性并推进以功效为中心的随机对照试验。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

Cultural adaptation is essential for optimizing programs centered around autonomy, such as the Serious Illness Care Program (SICP), especially for populations valuing family-involved decision-making.We aimed to evaluate the feasibility and efficacy of a culturally adapted SICP-based nurse-physician collaborative Advance Care Planning (ACP) intervention tailored for patients with advanced cancer who prefer family-involved decision-making.Oncology nurses, extensively trained and closely collaborating with physicians, conducted structured discussions with patients in the intervention group. The culturally adapted SICP-based ACP intervention was supplemented with trust-building, family involvement, and understanding of patient values. Primary inclusion criteria included patients within six weeks of initiating first-line palliative chemotherapy. Primary endpoints were achieving a 70% completion rate and assessing spiritual well-being (FACIT-Sp) at six months. Secondary endpoints included anxiety (GAD-7), depression (PHQ-9), quality of life (QOL) (CoQoLo), and ACP progress (ACP Engagement Scale) at the same interval.Forty-one patients (67.2%) completed the six-month follow-up, falling short of the targeted completion rate. The least-squares mean change from baseline in spiritual well-being at six months was 3.00 in the intervention group and -2.22 in the standard care group (difference, 5.22 points; 95% confidence interval, 1.38-9.06; P = 0.009). Similar superiority of the intervention was observed in QOL and ACP progress.Despite not meeting the targeted completion rate, the intervention group demonstrated enhanced spiritual well-being, QOL, and ACP progress. Our findings suggest revisions to the intervention manual to improve feasibility and to progress to an efficacy-focused randomized controlled trial.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.