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.

项目摘要 支持NIH的使命，该项目旨在探索一种新的护理模式，以增强生存护理 计划和促进局部前列腺癌（PCA）过渡到治疗后的患者的健康 自我管理。 PCA患者的生存护理计划很重要，因为发病率很高 美国PCA的发生率，与治疗相关的副作用的频繁发生以及生活质量降低 （QOL）在患者及其伴侣中（适用于合作的患者）。新兴证据表明 使用常规生存护理计划（SCP）并不能改善健康服务和患者的结果，因为 规定的SCP中的内容不考虑患者的信息和护理需求。我们计划整合 循证，理论驱动的症状自我管理计划，前列腺癌教育和资源 对于夫妻（PERC），具有标准化的SCP和增强的SCP（ESCP）。 ESCP将互动 生存护理计划中的患者和伴侣，并提供一站式全面的PERC 计划改善其QOL并减少患者对治疗后护理服务的使用。这对夫妇， 基于Web的量身定制PERC程序包括12个在线模块，带有作业，一个主持的聊天室和 资源中心。针对患者和伴侣的特征和偏好量量身定制 PERC的护理需求可帮助夫妻减少症状的负面评估，增加获得社会支持的机会， 并提高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的可行性（带有PERC Web链接的常规SCP）并进行初始好处 ESCPS评估。我们将使用两组（ESCP =干预，仅SCP =负面对照） 随机对照预测试的设计并在基线（T1）和4个月后（T2）收集数据 50例为局部PCA及其伴侣完成初始治疗的患者。具体目的是：目标1： 检查交付ESCP的可行性（按招聘，入学率和保留率评估， 对ESCP的满意度，并易于使用PERC）。我们将使用混合方法来实现这一目标。 AIM 2：估计ESCP的好处的大小。我们假设这是与仅SCP用户相比 ESCP用户将报告（1）QOL的主要结果（总体，物理，， 情感和社会质量）； （2）次要结果的改善（负面评估减少 以及改善自我效能感，社会支持和健康行为以控制症状）； （3）更少 从T1和T2之间访问治疗后护理服务。这项研究的结果将有助于设计 确定的随机试验测试ESCP的功效。创新的ESCP将加强生存护理 计划并允许PERC在无需昂贵的资源的情况下广泛和系统地传播 或人员。该提议的项目是对医学研究所的呼吁的回应， 美国癌症协会以解决与治疗相关的影响，并帮助癌症幸存者维持其质量。