MANAGING UNCERTAINTY IN STAGE B PROSTATE CANCER

管理 B 期前列腺癌的不确定性

• 批准号: 3393166
• 负责人: MERLE H MISHEL
• 金额: $ 36.55万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-30 至 1997-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3393166
• 关键词: African American; cancer rehabilitation /care; caregivers; caucasian American; emotional adjustment; family; health care cost /financing; human subject; mood disorders; nursing care evaluation; nursing intervention; oncology nursing; prostate neoplasms; quality of life; questionnaires; racial /ethnic difference; therapy compliance

The proposed study extends a successful nursing intervention for breast cancer patients to Caucasian and African-American men with Stage B prostate cancer and to their family care provider (FCP). This investigation provides a further test of the efficacy of the intervention with a different population and, including subset the family care provider, enables a test of two different structures for receiving the intervention: direct receipt or direct plus supplemented receipt via the FCP. The purposes of this study are: 1) to determine the effectiveness of an uncertainty management intervention delivered by a nurse via, telephone using two different structures for treatment delivery: directly to the patient, or directly to the patient plus supplemented through a family care provider in increasing compliance with treatment and enhancing quality of life; 2) to identify the characteristics of patients most in need of the intervention by examining, prior to the intervention, which person factors, disease factors and contextual factors are predictors of uncertainty, and life quality among Caucasian and African-American men diagnosed with stage B prostate cancer; 3) to determine the characteristics of patients with most benefit from the intervention by a) identifying whether the treatment is more effective for men predicted as needing the intervention based on person, disease and contextual factors associated with uncertainty at baseline; b) identifying,the effects of person, disease, and contextual factors plus time as mediators and moderators of treatment effectiveness on compliance with treatment, uncertainty, and life quality among experimental subjects; 4) to determine characteristics of the content and structure of the uncertainty management intervention that predict successful treatment outcomes; 5) to evaluate the dissemination procedure and utilization of the uncertainty management intervention by oncology nurses in community practice; 6) to estimate the cost effectiveness of the utilization of the uncertainty management protocol in practice. The design is a 3 X 2 repeated measures design with three levels of treatment (uncertainty management direct, uncertainty management direct plus supplemented and natural control condition) crossed with two levels of ethnicity (Caucasian and African-American). The measures are taken at baseline and 4 and 7 months post baseline. The intervention runs for 10 weeks and is delivered via weekly telephone calls. Multivariate models will be used to test for intervention effects, treatment need and benefit. During the final year of the study, efforts will be focused on disseminating the intervention protocol to oncology nurses in North Carolina through workshops conducted via the AHEC system. The utilization of the intervention and the costs associated with its adoption into practice will be estimated.

拟议的研究扩展了成功的乳房护理干预措施 癌症患者对B期的白种人和非裔美国人 前列腺癌及其家庭护理提供者（FCP）。 这 调查提供了对干预功效的进一步测试 人口不同，包括子集的家庭护理 提供者，启用了两个不同结构的测试 干预：直接收据或直接加上补充收据 FCP。这项研究的目的是：1）确定 护士通过电话提供的不确定性管理干预措施 使用两个不同的结构进行治疗：直接到达 患者，或直接给患者加上一个家庭补充的患者 护理提供者可以增加对治疗和增强的遵守 生活质量； 2）确定最大患者的特征 需要在干预之前检查干预措施， 人因素，疾病因素和情境因素是预测因素 高加索和非裔美国人的不确定性和生活质量 被诊断为B期前列腺癌； 3）确定 A的干预措施受益最多的患者的特征） 确定治疗对男性是否更有效 需要根据人，疾病和情境因素进行干预 与基线时的不确定性相关； b）确定，效果 人，疾病和上下文因素，以及作为调解人的时间 治疗有效性对遵守治疗的主持人， 实验学科之间的不确定性和生活质量； 4）确定 不确定性管理内容和结构的特征 预测成功治疗结果的干预措施； 5）评估 不确定性管理的传播程序和利用 肿瘤学护士在社区实践中的干预； 6）估计 利用不确定性管理的成本效益 实践中的协议。 设计是3 x 2重复措施设计，三个级别 治疗（不确定性管理直接，不确定性管理直接 加上补充和自然控制条件）与两个级别交叉 种族（高加索和非裔美国人）。这些措施是在 基线后基线以及4个月和7个月。干预措施为10 几周，并通过每周电话进行交付。 多元模型将用于测试干预效果， 治疗需求和利益。在研究的最后一年，努力 将专注于将干预方案传播到肿瘤学 北卡罗来纳州的护士通过通过AHEC系统进行的研讨会。 干预的利用及其相关的成本 将估计采用实践。