Ostomy Telehealth Self-management Training for Cancer Survivors

造口术远程医疗癌症幸存者自我管理培训

基本信息

批准号：
9904567
负责人：
Robert Scott Krouse
金额：
$ 64.65万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-01 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9904567
关键词：
Address Affect Aftercare Aging Area Behavioral Cancer Survivor Caregiver support Caring Chronic Chronic Care Chronic Disease Cognitive Communication Communities Complex Computer software Control Groups Costs and Benefits Counseling Dose Education Education Gap Educational Curriculum Elderly Enterostomal Therapy Nurse Specialist Equipment Event Exercise Face Family Fatigue Fees Financial Hardship Frustration Health Insurance Health Services Accessibility Health Status Healthcare Systems Insurance Coverage Knowledge Length of Stay Location Long-Term Care Malignant Neoplasms Malignant neoplasm of urinary bladder Medical Medical Care Costs Menu Planning Methods Nurses Operative Surgical Procedures Ostomy Pain Participant Patients Persons Postoperative Care Postoperative Period Problem Solving Rectal Cancer Rural Rural Community Rural Population Self Care Self Efficacy Self Management Stomas Survivors Techniques Third-Party Payer Time Training Travel Visit attentional control barrier to care base behavior change cancer care cancer education cancer therapy caregiver education comorbidity comparison intervention disability economic value evidence base frailty health related quality of life improved informal caregiver intervention participants intervention program nutrition operation patient oriented peer programs psychologic randomized controlled study response rural area self-management program service intervention skills social situation support network survivorship telehealth tool urinary

项目摘要

Cancer survivors with ostomies, most commonly rectal and bladder cancers, face complex adjustment issues. Typically, post-operative care does not adequately prepare cancer survivors for ostomy self-management, behavior change, psychological support or healthy living, which is requisite to assure optimal Health-Related Quality of Life (HRQOL). We developed an ostomy nurse and peer ostomate-led post-treatment chronic care- based Ostomy Self-Management Telehealth program (OSMT). This program is an education and support curriculum delivered in the group setting for both cancer survivors and their caregiver/support person. We received positive pilot feasibility results, but encountered major access barriers in patients getting to a centralized location to participate in the program. Therefore, we are utilizing telehealth as a delivery method to improve cancer survivor ability to participate. For this study, we will target patients living in rural and other nonmetro areas. The proposal is a randomized controlled study of our self-management program delivered by telehealth intervention compared to an Attention Control Condition (ACC) group. We expect OSMT subjects will improve patient activation, self-efficacy, HRQOL and knowledge via: 1) techniques for self-management to handle frustration, fatigue, pain, isolation, equipment, social situations; 2) overcoming barriers to appropriate exercise; 3) communication skills; 4) nutrition, menu planning, meal timing. In addition, we hope to show a cost benefit to the program, and evidence of reimbursement in the community. Aim 1: Using our enhanced telehealth techniques, determine if patient activation (PA), self-efficacy, ostomy- related knowledge, and HRQOL are improved and sustained over time, comparing OSMT and attention control condition (ACC) groups in rural populations. Aim 2: Determine whether third-party reimbursement for telehealth care encounters are comparable to those for in-person visits and adequate for supporting our OSMT intervention in rural areas.

接受造口术的癌症幸存者，最常见的是直肠癌和膀胱癌，面临着复杂的适应问题。通常，术后护理不能让癌症幸存者做好造口自我管理的充分准备，行为改变、心理支持或健康生活，这是确保最佳健康相关的必要条件生活质量（HRQOL）。我们开发了造口护士和同伴造口师主导的治疗后慢性护理- 基于造口术自我管理远程医疗计划（OSMT）。该计划是一项教育和支持在小组环境中为癌症幸存者及其护理人员/支持人员提供课程。我们获得了积极的试点可行性结果，但在患者获得治疗方面遇到了重大障碍参加该计划的集中地点。因此，我们利用远程医疗作为一种交付方法提高癌症幸存者的参与能力。在这项研究中，我们将针对生活在农村和其他地区的患者非都市区。该提案是对远程医疗提供的自我管理计划的随机对照研究与注意力控制条件（ACC）组相比进行干预。我们预计 OSMT 科目将会有所改善患者激活、自我效能、HRQOL 和知识，通过：1) 自我管理技术来处理挫折、疲劳、疼痛、孤立、设备、社交场合； 2）克服适当锻炼的障碍； 3）沟通能力； 4）营养、菜单规划、进餐时间。此外，我们希望向客户展示成本效益该计划以及社区报销的证据。目标 1：使用我们增强的远程医疗技术，确定患者激活 (PA)、自我效能、造口术是否比较 OSMT 和注意力控制，相关知识和 HRQOL 随着时间的推移得到改善和维持农村人口中的条件（ACC）群体。目标 2：确定远程医疗保健的第三方报销是否与其他报销相当用于亲自访问并足以支持我们在农村地区的 OSMT 干预。