Trajectories of QOL in Prostate Cancer Survivors using Growth Curve Modeling

使用生长曲线模型研究前列腺癌幸存者的生活质量轨迹

• 批准号: 7476125
• 负责人: Michael A Diefenbach
• 金额: $ 17.2万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7476125
• 关键词: Accounting; Address; Adverse effects; Affect; Affective; Age; Analysis of Variance; Anxiety; Area; Behavioral Research; Cancer Control; Cancer Patient; Cancer Survivor; Cancer Survivorship; Characteristics; Clinical; Consultations; Cross-Sectional Studies; Data; Data Set; Development; Diagnosis; Diagnostic; Disease; Doctor of Philosophy; Drops; Emotional; Exhibits; Fatigue; Feeling; Functional disorder; Gleason Grade for Prostate Cancer; Goals; Grant; Group Identifications; Growth; Health Personnel; Individual; Individual Differences; Intercept; Interdisciplinary Study; Intervention; Intestines; Investigation; Knowledge; Lead; Literature; Living Wills; Localized; Localized Disease; Malignant neoplasm of prostate; Marital Status; Masks; Measures; Mental Depression; Methodology; Methods; Modeling; Moods; Multivariate Analysis; Pain; Parents; Patients; Persons; Physicians; Population; Principal Investigator; Process; Prostatectomy; Psychologist; Public Health; Quality of life; Recovery; Regrets; Research; Review Literature; Risk; Score; Sex Functioning; Sexual Dysfunction; Shapes; Subgroup; Symptoms; Techniques; Thinking; Time; Treatment outcome; Urologist; base; cancer therapy; clinically significant; cognitive function; cost; experience; ideation; man; negative mood; programs; psychologic; research clinical testing; response; social; therapy design; urinary

DESCRIPTION: This proposal is in response to PA-04-034 "Exploratory Grants for Behavioral Research in Cancer Control." We propose to apply Growth Curve Analyses (GCA) to an existing dataset with longitudinal assessments of disease-specific and general quality of life (QOL) domains and psychological functioning of patients diagnosed with localized prostate cancer. Compared to a conventional multivariate approach, GCA provides a better way to examine individual change, explore correlates of change, and detect group differences in the process of change. GCA will identify trajectories of urinary and sexual functioning, general QOL, and psychological responses over time. These trajectories of functioning will provide a close approximation of a patient's actual experience following treatment. Such information can be used by clinicians to realistically prepare patients for possible treatment related side-effects including the timeframe when such side-effects might occur or subside. Ultimately, results can be used to identify at-risk patients for dysfunction, who then can be targeted for preparatory interventions. The three-year data set (N = 986 at baseline; n = 664 at 36 months; 67.3% retention) consists of six assessments of urinary and sexual functioning, general QOL(FACT-P) and extensive assessments of depression, anxiety, negative moods, and intrusive and avoidant ideation. Sensitivity analyses and imputation methods will be used to address potential biases in the data due to patient drop-out and missing data. The specific aims are: 1) To quantify trajectories of individual change in urinary and sexual functioning, QOL, and psychological functioning among prostate cancer survivors over 36 months; 2) to examine how these trajectories correlate with time invariant factors (e.g., treatment received, Gleason score, age); 3) to examine how trajectories of change in sexual and urinary function are associated with trajectories of change in QOL and psychological functioning; 4) to identify subgroups of patients with similar trajectories of sexual and urinary functioning. We hypothesize 1) that urinary and sexual dysfunction will be associated with lower levels of general QOL and psychological functioning over time; and 2) that subgroups of patients with similar trajectories of functioning exhibit distinct profiles or signatures characterized by clinical (i.e., urinary and sexual functioning) and psychological functioning (i.e., depression, intrusive and avoidant ideation). The proposed research is clinically significant in two ways: 1) identifying trajectories of functioning provides new information to health care providers of how urinary and sexual symptoms might develop over time; and 2) subgroups with similar demographic, clinical, and psychological profiles might be targets for interventions designed to prepare patients to anticipate treatment related side effects. PUBLIC HEALTH RELEVANCE: The proposed project is significant to public health for four main reasons: 1) The examination of trajectories of symptom experience and quality of life over time among prostate cancer patients is an unexplored area. 2) The information gained from the analyses can be used by clinicians to realistically prepare patients for possible treatment related side-effects including the time frame when such side-effects might occur or subside. 3) Results can be used to identify patients who might be at risk for dysfunction, who subsequently might be targeted for preparatory interventions. 4) The proposed analyses use data from an already existing data set, thus making this application a cost-effective approach to obtain new information and knowledge.

描述：该提案是对PA-04-034“用于癌症控制行为研究的探索性赠款”的回应。我们建议将生长曲线分析（GCA）应用于现有数据集，并对疾病特异性和一般生活质量（QOL）领域的纵向评估以及被诊断为局部前列腺癌的患者的心理功能。与常规的多元方法相比，GCA提供了一种更好的方法来检查个体变化， 探索变化的相关性，并在变化过程中检测群体差异。 GCA会随着时间的推移确定尿和性功能，一般质量和心理反应的轨迹。这些功能的轨迹将在治疗后的实际经验中近似近似。临床医生可以使用此类信息现实地为患者做好与治疗相关的副作用的准备，包括在可能发生副作用或消退时的时间范围。最终，结果可用于识别危险患者的功能障碍，然后将其作为预备干预措施的目标。三年数据集（基线时n = 986； n = 664时为36个月；保留率为67.3％）包括六次评估尿和性功能，QOL（FACT-P）以及对抑郁，焦虑，负面情绪以及侵入性和避免构想的广泛评估。敏感性分析和插补方法将用于解决数据中由于患者辍学和缺少数据而在数据中的潜在偏差。具体目的是：1）在36个月内量化前列腺癌幸存者中尿和性功能，QOL和心理功能的个体变化的轨迹； 2）检查这些轨迹如何与时间不变因素相关联（例如，接受的治疗，格里森评分，年龄）； 3）检查性和泌尿功能变化的轨迹与质量和心理功能变化的轨迹如何相关； 4）确定具有类似性和泌尿功能轨迹的患者的亚组。我们假设1）尿和性功能障碍将随着时间的流逝较低的一般QOL和心理功能而言； 2）患者亚组 具有相似的功能轨迹，表现出具有临床（即尿和性功能）和心理功能（即抑郁，侵入性和回避构想）的独特特征或特征。拟议的研究在两种方面具有临床意义：1）确定功能轨迹为卫生保健提供者提供了新的信息，以说明尿和性症状如何随着时间的流逝而发展； 2）具有相似人口，临床和心理特征的亚组可能是旨在准备患者预测治疗相关副作用的干预措施的目标。公共卫生相关性：拟议的项目对公共卫生而言是重要的，这是四个主要原因：1）前列腺癌患者随着时间的推移症状经验和生活质量的检查是未开发的领域。 2）临床医生可以使用从分析中获得的信息现实地为患者做好与治疗相关的副作用的准备，包括可能发生这种副作用或消退的时间范围。 3）结果可用于识别可能有功能障碍风险的患者，随后可能是针对准备干预措施的患者。 4）拟议的分析使用已经存在的数据集中的数据，从而使此应用程序成为获得新信息和知识的成本效益方法。