A Standardized Nursing Intervention Protocol for HCT Patients

HCT 患者的标准化护理干预方案

• 批准号: 7194274
• 负责人: MARCIA L. GRANT
• 金额: $ 41.76万
• 依托单位: BECKMAN RESEARCH INSTITUTE/CITY OF HOPE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-06 至 2010-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7194274
• 关键词: Acute; Advanced Practice Nurse; Advisory Committees; Age; Allogenic; Attention; Cancer Patient; Caregiver Burden; Caring; Cell Transplants; Cells; Characteristics; Clinical; Collaborations; Complication; Condition; Consultations; Control Groups; Diagnosis; Dimensions; Discipline of Nursing; Disease; Disease remission; Distress; Educational process of instructing; Ethnic Origin; Exercise; Gender; Goals; Grant; Healthcare Systems; Hematopoietic; Home environment; Home visitation; Hospitalization; Hospitals; House Call; Intervention; Knowledge; Life; Marital Status; Medical; Mental Health; Methods; Monitor; Morbidity - disease rate; Numbers; Nurses; Operative Surgical Procedures; Outcome; Patients; Pattern; Personal Satisfaction; Pharmaceutical Preparations; Phase II Clinical Trials; Population; Protocols documentation; Quality of life; Randomized; Randomized Clinical Trials; Research; Research Personnel; Risk; Self Care; Subgroup; Symptoms; Telephone; Testing; Time; Transplant Recipients; Transplantation; Treatment Protocols; Week; blind; design; disease characteristic; follow-up; functional status; improved; mortality; nursing intervention; nutrition; programs; protocol development; psychologic; psychosocial; skills; social; transplantation typing

DESCRIPTION (provided by applicant): Changes in the health care system have resulted in shifting a significant portion of care to the home environment where patients are responsible for care previously given by nurses in the acute care setting. This shift is especially evident in hematopoietic cell transplant (HCT) patients who have life-threatening disease and treatment and are acutely ill for months after hospital discharge. It is to this population that the advanced practice nurse (APN) can bring considerable knowledge and skill. The overall goal of this research is to improve outcomes for patients undergoing HCT by testing a Standardized Nursing Intervention Protocol for HCT Patients that integrates interdisciplinary patient teaching content. The study aims and hypotheses are to: Aim 1. Test the effects of a Standardized Nursing Intervention Protocol (SNIP) on overall QOL, (physical, psychological, social and spiritual well-being) and functional status for allogeneic HCT patients at discharge, 3, 6, and 12 months post hospitalization as compared to allogeneic patients who receive usual care plus attention control. Aim 2: Test the effects of SNIP-HCT on secondary outcomes of time-to-first complication, total number of complications, and mortality across groups. Aim 3: Identify subgroups of patients who benefit most from the SNIP-HCT in relation to sociodemographic characteristics, disease and clinical factors, and transplant factors. Aim 4: Decompose the effect on the SNIP-HCT on QOL into direct and indirect effects This Phase II study is designed as a longitudinal single blind, randomized clinical trial for allogeneic HCT patients. The framework includes an adaptation of McCorkle's SNIP approach, expanded to a population with numerous and persistent physical problems, as well as psychosocial and spiritual challenges. A total of 352 eligible HCT patients will be randomized to the SNIP-HCT or an attention control group. The six session teaching content for the experimental group is given by an advanced practice nurse in consultation with an interdisciplinary advisory committee. The experimental group receives multiple home visits and telephone calls for teaching and follow-up by an APN. Outcomes are evaluated at 3, 6 and 12 months post hospital discharge. The study builds on over ten years of research collaboration with an interdisciplinary HCT team.

描述（由申请人提供）：医疗保健系统的变化导致很大一部分护理转移到家庭环境，患者负责以前由护士在急症护理环境中提供的护理。这种转变在患有危及生命的疾病和治疗并且出院后数月内病情严重的造血细胞移植（HCT）患者中尤其明显。高级执业护士（APN）可以为这一人群带来丰富的知识和技能。本研究的总体目标是通过测试整合了跨学科患者教学内容的 HCT 患者标准化护理干预方案，改善接受 HCT 患者的治疗结果。该研究的目的和假设是： 目的 1. 测试标准化护理干预方案 (SNIP) 对出院时同种异体 HCT 患者的整体 QOL（身体、心理、社会和精神健康）和功能状态的影响，3与接受常规护理加注意力控制的同种异体患者相比，住院后 6 个月和 12 个月。目标 2：测试 SNIP-HCT 对各组次要结局（首次出现并发症的时间、并发症总数和死亡率）的影响。目标 3：根据社会人口学特征、疾病和临床因素以及移植因素，确定从 SNIP-HCT 中获益最多的患者亚组。目标 4：将 SNIP-HCT 对 QOL 的影响分解为直接影响和间接影响 这项 II 期研究被设计为针对同种异体 HCT 患者的纵向单盲、随机临床试验。该框架包括对 McCorkle 的 SNIP 方法的改编，扩展到存在大量且持续的身体问题以及社会心理和精神挑战的人群。总共 352 名符合条件的 HCT 患者将被随机分配到 SNIP-HCT 组或注意对照组。实验组的六节教学内容由高级执业护士与跨学科咨询委员会协商后提供。实验组多次接受 APN 的家访和电话指导和跟踪。出院后 3、6 和 12 个月对结果进行评估。该研究建立在与跨学科 HCT 团队十多年的研究合作基础上。