Simultaneous Care: Linking Palliation to Clinical Trials

同步护理：将姑息治疗与临床试验联系起来

• 批准号: 6918510
• 负责人: FREDERICK J. MEYERS
• 金额: $ 52.02万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-25 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6918510
• 关键词: caregivers; clinical research; clinical trials; family structure /dynamics; human subject; human therapy evaluation; information dissemination; neoplasm /cancer education; neoplasm /cancer palliative treatment; neoplasm /cancer therapy; patient oriented research; quality of life; terminal patient care; training

DESCRIPTION (provided by applicant): This project will implement a Simultaneous Care Educational Intervention (SCEI) for patients and caregivers and evaluate related outcome variables in three cancer centers. The project has four aims and ten objectives. Aim 1 includes the implementation phase of the proposal and evaluates process outcomes that will guide future dissemination of the SCEI into the nation?s cancer centers. Aim 2 involves measurement of the impact of the intervention on patients. Aim 3 is the measurement of effect of the SCEI on families. Aim 4 addresses the dissemination of results of the SCEI and implementation in other cancer treatment settings. The specific aims will be accomplished using a quasiexperimental design with repeated measures. The assessments will be obtained using two pre-education measures, and assessments every thirty days for six months. The assessment points following the intervention will provide data regarding the effectiveness of the educational intervention on patients and family caregivers outcomes. The SCEI uses the COPE model (Creativity, Optimism, Planning and Expert Information) developed by D?Zurilla and Nezu, as one of its key components, for cancer patients on Phase I and II clinical trials, and combined it with a structured coaching model with the patient and caregiver to reinforce the educational intervention. The SCEI teaches patients and caregivers a problem solving approach for dealing with issues and problems common with advanced disease, and sets up a system for coaching the patient and caregiver for reinforcement of the new skills. Patients and family caregivers are taught a standardized, strategic approach to problemsolving, learn and practice new communication skills and receive periodic reinforcement and guidance from staff educators. The model uses patient/family caregiver education as file vehicle to support and sustain the patient/family constellation through the clinical trial while raising critical end-of-life and palliative issues. By applying this approach to the full range of difficulties encountered in the advanced illness and clinical trials arenas, patients and families can obtain crucial services and support while simultaneously planning for and working through difficult decisions. Based on prior individual and collaborative work, the investigators anticipate that patients and family caregivers will experience reduced distress, good symptom control, and improved quality-of-life. In addition, the enhanced communication skills of both patients and caregivers will lead to earlier identification and intervention with protocol-related complications and will promote improved recruitment and retention on clinical trials, more appropriate resource utilization, and increased frequency and duration in the use of hospice/supportive care. Having introduced and evaluated the intervention, we will disseminate the findings of the SCEI implementation and evaluation by hosting a national training program for 50 cancer centers. We will also monitor implementation of SCEI by these 50 cancer centers in their own settings. A comprehensive plan for the dissemination of the model and results to community and comprehensive cancer centers with follow-up to measure durable change completes this project.

描述（由申请人提供）：该项目将实施 针对患者和护理人员的同步护理教育干预 (SCEI) 并评估三个癌症中心的相关结果变量。项目 有四个目的和十个目标。目标 1 包括实施阶段 提案并评估将指导未来的流程结果 将 SCEI 传播到全国癌症中心。目标 2 涉及 测量干预措施对患者的影响。目标 3 是 衡量 SCEI 对家庭的影响。目标 4 解决了 传播 SCEI 的结果以及在其他癌症中的实施 治疗设置。具体目标将通过准实验来实现 重复测量设计。将获得评估结果 使用两项预教育措施，并每三十天进行一次评估，共六次 几个月。干预后的评估点将提供数据 关于对患者进行教育干预的有效性以及 家庭照顾者的成果。 SCEI 使用 COPE 模型（创造力、 乐观、计划和专家信息）由 D?Zurilla 和 Nezu 开发，如 其关键成分之一，针对处于 I 期和 II 期临床的癌症患者 试验，并将其与患者和患者的结构化辅导模型相结合 护理人员加强教育干预。 SCEI 教授 患者和护理人员处理问题和解决问题的方法 建立晚期疾病常见问题的指导体系 患者和护理人员加强新技能。患者和 向家庭照顾者传授标准化的、战略性的解决问题的方法， 学习和练习新的沟通技巧并定期接受 员工教育工作者的强化和指导。该模型使用 患者/家庭护理人员教育作为支持和维持的档案工具 通过临床试验同时提出关键问题的患者/家属星座 临终和姑息治疗问题。通过将这种方法应用到全面 晚期疾病和临床试验中遇到的一系列困难 场馆、患者和家庭可以获得重要的服务和支持，同时 同时规划并完成艰难的决定。基于 在之前的个人和协作工作中，研究人员预计 患者和家庭护理人员将感受到减轻的痛苦和良好的症状 控制，提高生活质量。此外，增强的 患者和护理人员的沟通技巧将有助于更早地 识别和干预与方案相关的并发症和意愿 促进改善临床试验的招募和保留，更多 适当的资源利用，并增加频率和持续时间 使用临终关怀/支持性护理。介绍并评估了 干预，我们将传播 SCEI 实施的结果和 通过为 50 个癌症中心举办国家培训计划进行评估。我们 还将监测这 50 个癌症中心在其各自地区的 SCEI 实施情况 自己的设置。传播模型的综合计划和 将结果发送给社区和综合癌症中心并进行后续跟踪 衡量持久的变化来完成这个项目。