Enhancing End-of-Life and Bereavement Outcomes Among Cancer Caregivers

改善癌症护理人员的临终和丧亲结果

基本信息

批准号：
8662206
负责人：
KATHLEEN H MOONEY
金额：
$ 203.13万
依托单位：
UNIVERSITY OF UTAH
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-05-19 至 2016-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8662206
关键词：
Accounting Address Affect Age American Bereavement Bereavement Care Cancer Patient Cancer Science Caregivers Caring Cessation of life Clinical Trials Code Communication Computers Data Discipline Disease Distress Effectiveness of Interventions Emotional Ethical Issues Family Family Caregiver Family member Feeling Foundations Goals Health Health Personnel Health Professional Healthcare Systems Home environment Home visitation Hospitals House Call Human Individual Institute of Medicine (U.S.)Instruction Interdisciplinary Study Intervention Knowledge Knowledge acquisition Left Life Location Mails Malignant Neoplasms Medical Methods Modeling Nurses Nursing Staff Outcome Palliative Care Palliative Care Nursing Pathway interactions Patient Monitoring Patients Pattern Persons Pharmaceutical Preparations Process Program Research Project Grants Property Public Health Quality of Care Randomized Recommendation Reporting Research Research Infrastructure Research Project Grants Resources Risk Roter Science Severities Spouses Symptoms System Systems Analysis Technology Telecommunications Telephone Testing Time United States National Institutes of Health Wood material base caregiving coping design directed attention effective intervention end of life experience hospice environment improved loved ones mortality novel strategies programs prospective psychologic skills symposium symptom management treatment as usual

项目摘要

PROJECT SUMMARY (See Instructions): Combining the strengths of three interdisciplinary research teams, the goals of this program project are: 1. to advance the science of cancer end-of-life and bereavement care by exploring and intervening to improve the experience and outcomes for spouse/partner caregivers; 2. to expedite the formation of a new interdisciplinary science team from three separate programs of research, leveraging different perspectives to improve understanding and produce meaningful interventions that address the continuum of end-of-life and bereavement care; 3. to extend research questions beyond those possible through individual studies and existing research programs and; 4. to accelerate and expand the dissemination of effective end-of-life and bereavement models, methods and findings, The goals will be accomplished through implementation of three theoretically based research projects sharing one implementation core which provides the infrastructure and coordination among the projects. The first project, Symptom Care by Phone (SCP), a prospective clinical trial, will test an automated computer based telecommunication system that assesses severity and distress from physical and psychological symptoms common at the end-of-life, sends e-mail alerts to the hospice nurse of unrelieved symptoms and provides tailored management strategies to spouse/partner caregivers based on the individual symptom pattern. 300 home hospice cancer patients age 50+ and their caregivers will be randomized to intervention or usual care. The second project, Nurse-Caregiver Communication (NCC) will begin simultaneously. It will examine communication patterns and trajectories of communication during audio taped hospice RN home visits with the 300 caregivers. These interactions will be coded with the Roter Interaction Analysis System. The third project, Individualized Dual Process Model (DPM), will test the effectiveness of an intervention to enhance coping processes and outcomes of the spouse/partner caregivers during bereavement. 160 bereaved caregivers from the SCP project will be randomly selected and assigned to one of the two DPM project groups. Additional synergistic, interdependent aims will address cross project questions and extend the depth and breadth of the analyses using both pre and post death data.

项目摘要（参见说明）：结合三个跨学科研究团队的优势，该项目的目标是： 1. 通过探索和干预改善配偶/伴侣照顾者的体验和结果，推进癌症临终和丧亲护理的科学； 2. 加快由三个独立的研究项目组成的新的跨学科科学团队，利用不同的观点来增进理解并制定有意义的干预措施，以解决临终关怀和丧亲之痛的连续性问题； 3. 通过个人研究和现有研究计划将研究问题扩展到可能的范围之外； 4. 为了加速和扩大有效的临终和丧亲模型、方法和研究结果的传播，将通过实施三个基于理论的研究项目来实现这些目标，这些项目共享一个实施核心，为项目之间提供基础设施和协调。第一个项目是电话症状护理 (SCP)，这是一项前瞻性临床试验，将测试基于计算机的自动化电信系统，该系统评估临终时常见的身体和心理症状的严重程度和痛苦，并向临终关怀护士负责处理未缓解的症状，并根据个人症状模式为配偶/伴侣护理人员提供量身定制的管理策略。 300 名 50 岁以上的家庭临终癌症患者及其护理人员将被随机分配接受干预或常规护理。第二个项目“护士与护理人员沟通”(NCC) 将同时开始。它将检查临终关怀中心 RN 家访期间与 300 名护理人员进行录音的沟通模式和沟通轨迹。这些交互将使用 Roter 交互分析系统进行编码。第三个项目是个性化双重过程模型（DPM），将测试干预措施的有效性，以增强配偶/伴侣照顾者在丧亲期间的应对过程和结果。 SCP 项目中的 160 名失去亲人的照顾者将被随机挑选并分配到两个 DPM 项目组之一。其他协同、相互依赖的目标将解决跨项目问题，并使用死亡前后数据扩展分析的深度和广度。