Living Well: A Web-based Intervention to Improve Quality of Life in Rural and Urban Ovarian Cancer Survivors

美好生活：基于网络的干预措施，提高农村和城市卵巢癌幸存者的生活质量

基本信息

批准号：
10547784
负责人：
SUSAN K LUTGENDORF
金额：
$ 60.26万
依托单位：
UNIVERSITY OF IOWA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-02-01 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10547784
关键词：
Age Animals Anxiety Attention Behavioral Biological Process Cancer Patient Cancer Survivor Cancer Survivorship Caring Chronic Clinic Clinical Cognitive Coping Skills Data Development Diagnosis Disease Disease Progression Distress Elements Fatigue Goals Gynecologic Oncology Health Benefit Health Promotion Home Incidence Internet Intervention Longterm Follow-up Malignant Female Reproductive System Neoplasm Malignant Neoplasms Malignant neoplasm of ovary Mediating Mental Depression Moods Online Systems Outcome Outcome Measure Participant Patients Population Prognosis Public Health Quality of life Randomized, Controlled Trials Recurrence Relaxation Reporting Research Rural Site Social isolation Stress Support System Survival Rate Survivors Symptoms Targeted Research Testing Time Travel Tumor Promotion Videoconferencing Woman Work acceptability and feasibility active control cohort coping depressive symptoms direct application efficacy evaluation evidence base experience health related quality of life implementation barriers improved in vitro Model innovation intervention effect mindfulness mindfulness-based stress reduction novel perceived stress physical symptom poor sleep primary outcome programs psychosocial rural setting secondary outcome side effect skills stress management stress reduction symposium therapy design tumor progression urban residence web-based intervention

项目摘要

Abstract Over the last two decades, we and others have documented the chronic and often debilitating experience of ovarian cancer survivorship which may include poor health related quality of life (HRQOL), elevated anxiety and depression, poor sleep, fatigue, multiple symptoms/side effects, existential concerns, and a generally poor prognosis. Because of compromises to many aspects of HRQOL combined with low rates of survival for the majority of these patients, development of innovative approaches for improving HRQOL and potentially improving clinical outcomes is of paramount importance. This need is particularly true in rural settings where women may have less access to clinic-based support systems. Despite the multiple challenges experienced by ovarian cancer survivors, research targeting the potential efficacy of psychosocial interventions in enhancing HRQOL has been extremely limited. Over the last several years this research team has developed and piloted a web-based group conferencing intervention entitled Living Well (Web-Enhanced Lessons for Living) targeting key concerns of ovarian cancer survivors and developed with input from survivors. The overarching goal of the present submission is to examine the efficacy of the Living Well intervention vs. a Health Promotion active control intervention in a randomized controlled trial in 256 ovarian cancer survivors who have completed primary treatment and are less than 5-years post-diagnosis. We hypothesize that the Living Well Intervention will be efficacious in improving HRQOL, decreasing perceived stress (primary outcomes) and in decreasing depressive mood, anxiety, and fatigue (secondary outcomes). This application is highly innovative because it combines elements of evidence-based psychosocial interventions in a novel way to target the needs of ovarian cancer survivors, using a state-of-the-art web and video conferencing platform that allows wide dissemination, including to rural survivors. This work is highly translational as it is a direct application of findings from mechanistic stress-related research to testing an intervention to reduce stress in ovarian cancer survivors. The significance of the application is that this intervention has the potential to overcome prior barriers to the implementation of such psychosocial interventions and improve HRQOL, thus providing public health benefits to an understudied and compromised cancer population with a high likelihood of recurrence.

抽象的在过去的二十年里，我们和其他人记录了这种长期且常常令人衰弱的经历卵巢癌存活率的影响，其中可能包括与健康相关的生活质量 (HRQOL) 较差、升高焦虑和抑郁、睡眠不佳、疲劳、多种症状/副作用、存在问题以及一般预后不良。由于 HRQOL 的许多方面都受到了影响，加上比率较低大多数患者的生存，开发创新方法来改善HRQOL 潜在地改善临床结果至关重要。这种需求在以下情况尤其如此：在农村地区，妇女获得诊所支持系统的机会可能较少。尽管有多个卵巢癌幸存者经历的挑战，针对潜在功效的研究提高 HRQOL 的心理社会干预极其有限。过去几年该研究团队开发并试行了一种基于网络的小组会议干预措施，名为 Living Well（网络增强生活课程）针对卵巢癌幸存者的关键问题和根据幸存者的意见制定。本次提交的总体目标是审查随机对照试验中“健康生活”干预措施与“健康促进”主动控制干预措施的效果对 256 名卵巢癌幸存者进行的对照试验，这些幸存者已完成初级治疗并且病情低于诊断后 5 年。我们假设健康生活干预措施将有效改善 HRQOL，减少感知压力（主要结果）并减少抑郁情绪、焦虑、和疲劳（次要结果）。该应用程序具有高度创新性，因为它结合了以下元素以一种新颖的方式针对卵巢癌幸存者的需求进行基于证据的心理社会干预，使用最先进的网络和视频会议平台进行广泛传播，包括农村幸存者。这项工作具有高度转化性，因为它是机械论研究结果的直接应用与压力相关的研究，旨在测试减轻卵巢癌幸存者压力的干预措施。这该应用的意义在于，这种干预有可能克服先前的障碍实施此类社会心理干预措施并改善 HRQOL，从而提供公共卫生对研究不足且复发可能性高的癌症人群有好处。