Use of HIT to Improve Symptom Mgt in Advanced Cancer

使用 HIT 改善晚期癌症的症状管理

• 批准号: 7121605
• 负责人: JEAN S KUTNER
• 金额: $ 14.79万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-12 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7121605
• 关键词: Internet; behavioral /social science research tag; caregivers; clinical research; clinical trials; computer assisted patient care; computer human interaction; computer system design /evaluation; health care service evaluation; health services research tag; hospices; human subject; human therapy evaluation; neoplasm /cancer palliative treatment; nurse patient relations; patient care personnel relations; patient oriented research; quality of life; satisfaction; telemedicine; terminal patient care

DESCRIPTION (provided by applicant): Seriously ill and dying patients often suffer from treatable symptoms, both physical and psychological. There are several possible explanations for the persistence of significant symptom distress in this setting and population: 1) Patient-level pharmacologic or non-pharmacologic interventions may ineffective or inadequately studied in the terminally ill population; 2) Care providers (either informal or professional) may not recognize symptom distress, leading to under treatment of distressing symptoms; 3) Those who are experiencing the symptom distress (patients) and those who have the ability to address the distress (health care providers) may not have effective means of communicating. The purpose of this proposed project is to study the feasibility and determine preliminary effect sizes of implementing a patient-centered technology-based system for improving symptom management in hospice/palliative care settings. The Specific Aims of the proposed project are to: 1) Develop, test and refine components of a patient-centered health information technology (HIT) intervention that incorporates sequential standardized symptom and quality of life assessments with real-time feedback into routine care; and 2) Conduct a feasibility study of the reach and effectiveness of the patient-centered symptom management HIT intervention with diverse organizations providing hospice/palliative care and diverse people with advanced cancer receiving care from these organizations. This feasibility study will test a bi-directional system where patients, informal caregivers and hospice/palliative care providers can enter data and receive reports that summarize symptom distress information and prompt care interventions. The study will be conducted in a community-based hospice/palliative care research network. If shown feasible as a two-way symptom management and alerting system, the patient-centered system may be adapted to assist with symptom management in other settings and other cancer stages. Findings from this project will inform preparation of an R01 proposal for a larger-scale randomized clinical trial to test the efficacy of the symptom management HIT intervention for decreasing symptom distress among persons with advanced cancer.

描述（由申请人提供）：重病和垂死的患者通常会遭受可治疗的身体和心理症状。对于这种环境和人群中持续存在的显着症状困扰有几种可能的解释：1）患者层面的药物或非药物干预措施可能在末期疾病人群中无效或研究不充分； 2) 护理提供者（无论是非正式的还是专业的）可能无法识别症状困扰，导致对困扰症状的治疗不足； 3) 那些正在经历症状困扰的人（患者）和有能力解决困扰的人（医疗保健提供者）可能没有有效的沟通方式。该拟议项目的目的是研究实施以患者为中心的基于技术的系统的可行性并确定初步效果大小，以改善临终关怀/姑息治疗环境中的症状管理。拟议项目的具体目标是： 1) 开发、测试和完善以患者为中心的健康信息技术 (HIT) 干预措施的组成部分，该干预措施将顺序标准化症状和生活质量评估与实时反馈结合到日常护理中； 2) 与提供临终关怀/姑息治疗的不同组织以及接受这些组织护理的不同晚期癌症患者一起，对以患者为中心的症状管理 HIT 干预的范围和有效性进行可行性研究。这项可行性研究将测试一个双向系统，患者、非正式护理人员和临终关怀/姑息治疗提供者可以输入数据并接收总结症状困扰信息和及时护理干预的报告。该研究将在基于社区的临终关怀/姑息治疗研究网络中进行。如果作为双向症状管理和警报系统被证明是可行的，以患者为中心的系统可以适用于协助其他环境和其他癌症阶段的症状管理。该项目的研究结果将为更大规模随机临床试验的 R01 提案的准备提供信息，以测试症状管理 HIT 干预措施对减少晚期癌症患者症状困扰的功效。

项目成果

Feasibility of a telephone-based counseling program for informal caregivers of hospice patients.

为临终关怀患者的非正式护理人员提供电话咨询计划的可行性。

• 发表时间: 2011-11
• 影响因子: 2.8
• 作者: Kilbourn, Kristin M;Costenaro, Allison;Madore, Shannon;Deroche, Kate;Anderson, Derek;Keech, Tarah;Kutner, Jean S
• 通讯作者: Kutner, Jean S