Enhancing Survivorship Care Planning for Patients with Localized Prostate Cancer Using A Couple-focused Web-based Tailored Symptom Self-management Program

使用以夫妇为中心、基于网络的定制症状自我管理计划，加强局限性前列腺癌患者的生存护理计划

• 批准号: 9225993
• 负责人: Lixin Song
• 金额: $ 19.84万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-12-01 至 2018-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9225993
• 关键词: Address; Adverse effects; Advertising; Aftercare; Age; American Cancer Society; Area; Behavior; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caring; Cellular Phone; Characteristics; Computers; Control Groups; Couples; Data; Diet; E-learning; Effectiveness; Emotional; Enrollment; Family; Fatigue; Feasibility Studies; Generic Drugs; Guidelines; Health; Health Services; Health behavior; Hormonal; Human Resources; Incidence; Institute of Medicine (U.S.); Internet; Intervention; Intestines; Knowledge; Learning Module; Link; Malignant Neoplasms; Malignant neoplasm of prostate; Methods; Mission; Modeling; Nature; Newly Diagnosed; Online Systems; Organism; Outcome; Pain; Participant; Patient Care Planning; Patient-Focused Outcomes; Patients; Physical activity; Provider; Quality of life; Randomized; Randomized Clinical Trials; Recruitment Activity; Reporting; Resources; Self Efficacy; Self Management; Services; Sleep disturbances; Slide; Social support; Standardization; Suggestion; Support Groups; Supportive care; Survivors; Symptoms; Tablets; Technology; Testing; Text; Time; United States National Institutes of Health; Visit; active method; base; cancer care; cancer education; cost; design; efficacy testing; emotional distress; evidence base; group intervention; improved; innovation; mHealth; men; neoplasm resource; peer support; preference; primary outcome; programs; randomized trial; response; retention rate; routine care; satisfaction; secondary outcome; skills training; social; survivorship; symptom management; symptom self management; symptomatic improvement; theories; tool; uptake; urinary

PROJECT SUMMARY Supporting NIH's mission, this project aims to explore a new model of care that enhances survivorship care planning and promotes health for patients with localized prostate cancer (PCa) transitioning to post-treatment self-management. Survivorship care planning for patients with PCa is important because of the high incidence rates of PCa in the U.S., the frequent occurrence of treatment-related side effects, and reduced quality of life (QOL) in both patients and their partners (for patients who are partnered). Emerging evidence suggests that use of regular survivorship care plans (SCPs) does not improve health service and patient outcomes because the content in mandated SCPs does not consider patients' information and care needs. We plan to integrate an evidence-based, theory-driven symptom self-management program, Prostate Cancer Education & Resources for Couples (PERC), with standardized SCPs and build enhanced SCPs (ESCPs). ESCPs will engage both patients and partners during survivorship care planning and provide a one-stop, comprehensive PERC program to improve their QOL and decrease patient use of post-treatment care services. The couple-focused, web-based tailored PERC program includes 12 online modules with assignments, a moderated chat room and a resource center. Tailored to patients' and partners' characteristics and preferences to address their specific care needs, PERC helps couples reduce negative appraisals of symptoms, increase access to social support, and enhance self-efficacy and health behaviors for symptom self-management. In this study, we propose to test the feasibility of ESCPs (regular SCPs with the PERC web link) and to conduct an initial benefit assessment of ESCPs. We will use a two-group (ESCP=intervention and SCP only=negative control) randomized controlled pretest-posttest design and collect data at baseline (T1) and 4 months later (T2) among 50 patients completing initial treatment for localized PCa and their partners. The specific aims are: Aim 1: Examine the feasibility of delivering ESCPs (as assessed by recruitment, enrollment, and retention rates, satisfaction with ESCP, and perceived ease of use of PERC). We will use mixed methods to achieve this aim. Aim 2: Estimate the magnitude of benefit of ESCPs. We hypothesize that, compared with the SCP only users, the ESCP users will report (1) greater improvement in their primary outcomes of QOL (overall, physical, emotional, and social QOL); (2) greater improvement in secondary outcomes (reduction in negative appraisals and improvement in self-efficacy, social support, and health behaviors to manage symptoms); and (3) fewer visits to post-treatment care services from between T1 and T2. The results from this study will help design a definitive randomized trial to test the efficacy of ESCP. The innovative ESCPs will strengthen survivorship care planning and allow PERC to be disseminated broadly and systematically without the need for costly resources or personnel. This proposed project is in response to calls for programs from the Institute of Medicine and American Cancer Society to address treatment-related effects and help cancer survivors maintain their QOL.

项目概要 该项目旨在支持 NIH 的使命，旨在探索一种增强幸存者护理的新护理模式 规划并促进局部前列腺癌 (PCa) 患者过渡到治疗后的健康 自我管理。由于 PCa 发病率高，生存护理计划非常重要 美国前列腺癌​​的发病率、治疗相关副作用的频繁发生以及生活质量的下降 患者及其伴侣（对于有伴侣的患者）的生活质量（QOL）。新出现的证据表明 使用定期生存护理计划 (SCP) 并不能改善医疗服务和患者治疗结果，因为 强制 SCP 中的内容未考虑患者的信息和护理需求。我们计划整合一个 循证、理论驱动的症状自我管理计划，前列腺癌教育和资源 情侣 (PERC)，具有标准化 SCP 并构建增强型 SCP (ESCP)。 ESCP 将同时吸引双方 在幸存者护理计划期间为患者和合作伙伴提供帮助，并提供一站式、全面的 PERC 旨在提高患者生活质量并减少患者使用治疗后护理服务的计划。以情侣为中心， 基于网络的定制 PERC 计划包括 12 个带有作业的在线模块、一个主持的聊天室和 资源中心。根据患者和伴侣的特征和偏好量身定制，以解决他们的具体问题 护理需求，PERC 帮助夫妇减少对症状的负面评价，增加获得社会支持的机会， 并增强自我效能和健康行为以进行症状自我管理。在这项研究中，我们建议 测试 ESCP（带有 PERC 网络链接的常规 SCP）的可行性并进行初步效益 ESCP 评估。我们将使用两组（ESCP = 干预，仅 SCP = 阴性对照） 随机对照前测后测设计并收集基线 (T1) 和 4 个月后 (T2) 的数据 50 名完成局部 PCa 初始治疗的患者及其伴侣。具体目标是： 目标 1： 检查提供 ESCP 的可行性（通过招聘、入学率和保留率进行评估， 对 ESCP 的满意度以及 PERC 的易用性感知）。我们将使用混合方法来实现这一目标。 目标 2：估计 ESCP 的效益程度。我们假设，与仅使用 SCP 的用户相比， ESCP 用户将报告 (1) 他们的 QOL 主要结果（总体、身体、 情感和社交生活质量）； (2) 次要结果有更大改善（负面评价减少） 以及改善自我效能、社会支持和健康行为以管理症状）； (3) 更少 T1 和 T2 之间访问治疗后护理服务的次数。这项研究的结果将有助于设计一个 测试 ESCP 功效的最终随机试验。创新的 ESCP 将加强幸存者护理 规划并允许 PERC 广泛、系统地传播，而不需要昂贵的资源 或人员。该拟议项目是为了响应医学研究所的计划呼吁 美国癌症协会致力于解决治疗相关的影响并帮助癌症幸存者维持生活质量。