Building Family Caregiver Skills Using a Simulation-Based Intervention for Care of Patients with Cancer

使用基于模拟的干预措施来培养癌症患者的家庭护理人员技能

基本信息

批准号：
10580328
负责人：
Susan Mazanec
金额：
$ 46.47万
依托单位：
CASE WESTERN RESERVE UNIVERSITY
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：
2019-07-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10580328
关键词：
Active Learning Address Adverse event Affect Aftercare Anus Anxiety Cancer Center Cancer Family Caregivers Caring Clinical Colostomy Procedure Combined Modality Therapy Communication Complex Comprehensive Cancer Center Control Groups Data Decision Making Dehydration Demographic Factors Distress Division of Cancer Control and Population Sciences Education Educational Intervention Educational process of instructing Effectiveness Emergency department visit Emotional Enteral Feeding Esophagus Event Face Family Family Caregiver Family member Fatigue Feeling Goals Head and Neck Cancer Head and neck structure Health Health Professional Healthcare Systems Hospitalization Hour IV Fluid Impairment Individual Interruption Intervention Lead Location Malignant Neoplasms Malignant neoplasm of anus Malignant neoplasm of esophagus Malignant neoplasm of lung Malnutrition Measures Mediating Mediation Medical Care Team Mental Depression Methods Mission Modality Modeling National Cancer Institute Non-Small-Cell Lung Carcinoma Nutritional Oncology Operative Surgical Procedures Outcome Pain management Patient Care Patient-Focused Outcomes Patients Persons Play Population Preparation Problem Solving Process Prognosis Psychosocial Influences Quality of Care Radiation Radiation therapy Randomized, Controlled Trials Rectal Cancer Rectum Reporting Research Role Self Efficacy Self Management Skin Structure Symptoms Techniques Telephone Testing Time Tracheostomy procedure Training Translating Treatment Side Effects Treatment outcome University Hospitals Well in self cancer therapy care delivery care recipients caregiver education caregiver interventions caregiving chemotherapy clinical practice cost comparison design educational atmosphere experience family building family management functional disability health care service utilization health related quality of life health training improved intervention effect novel pilot test point of care primary caregiver prospective psychoeducation psychoeducational psychoeducational intervention psychological distress randomized trial recruit rectal simulation skill acquisition skills skills training survivorship symptom management usual care arm virtual wound

项目摘要

Project Summary/Abstract: Patients with head and neck, lung, esophageal, rectal, and anal cancers typically undergo rigorous, intense, combined-modality treatment (radiation, surgery, and/or chemotherapy) and experience high symptom burden, functional impairment, and complex psychosocial issues. Positive treatment outcomes and avoidance of complications are dependent largely on the adequacy of care provided by family members. However, family caregivers (CGs) report feeling unprepared to assume the multiple, complex tasks of caregiving, including tangible help with tracheostomy care, tube feedings, wound and colostomy care, pain management, and ongoing emotional support. Despite being a critical extension of the oncology healthcare team, training of CGs to manage symptoms, deal with communication issues with care recipients, and take care of their own physical and emotional health, is not integrated into clinical practice. This study will measure the effect of a psychoeducational and skills training intervention that incorporates structured simulation or experiential learning to improve CG, patient, and healthcare utilization outcomes. Simulation is effective in training healthcare professionals, but little is known about its effectiveness in training family CGs. The intervention is designed for the period of active cancer treatment and the immediate transition to posttreatment survivorship, a time when the CG and patient are most vulnerable. The specific aims of this 2-group, prospective, randomized controlled trial are to: (1) evaluate the effect of a CG intervention, as compared to a control group, on CG primary (anxiety) and secondary (depression, health-related quality of life [HRQOL], and fatigue) outcomes; (2) measure the effect of the intervention on patient outcomes (HRQOL and interrupted treatment course) and healthcare utilization outcomes (unplanned hospital admission, unplanned emergency room visits, and unplanned use of intravenous fluids); (3) determine if CG self-efficacy mediates the effect of the intervention on CG anxiety; (4) determine if patient illness factors, care demands, and patient and CG demographic factors moderate the relationship between the intervention and CG outcomes; and (5) compare the costs of healthcare utilization between the intervention and control groups. We will recruit 180 CGs from University Hospitals Seidman Cancer Center at the Case Comprehensive Cancer Center. The intervention involves three in-person, one-on-one sessions during radiation treatments, followed by a telephone contact 2 weeks posttreatment. Data will be collected at baseline, at the end of radiation treatment, and 4 and 20 weeks postradiation treatment. The analysis will consist of linear mixed model repeated measures, mediation and moderation tests, and Poisson regression methods. The proposed project addresses National Cancer Institute's Division of Cancer Control and Population Sciences mission of improving the delivery of care to individuals and family members affected by cancer. The study findings will provide crucial information for translating the psychoeducational and simulation methods used in this intervention to other CG populations and clinical settings.

项目摘要/摘要：头颈，肺，食管，直肠和肛门癌的患者通常会经历严格，强烈，强烈，合并模式治疗（放射线，手术和/或化学疗法）并经历高症状负担，功能障碍和复杂的社会心理问题。积极的治疗结果和避免并发症在很大程度上取决于家庭成员提供的护理充分性。但是，家庭护理人员（CGS）报告没有准备好承担多重，复杂的护理任务，包括在气管切开术，管喂养，伤口和结肠造口护理，疼痛管理和持续的情感支持。尽管是肿瘤医疗团队的关键延伸，但CGS的培训管理症状，处理护理接收者的沟通问题，并照顾好自己的身体情绪健康并未融入临床实践中。这项研究将衡量心理教育和技能培训干预措施，结合结构化模拟或体验学习改善CG，患者和医疗保健利用结果。模拟有效训练医疗保健专业人员，但对培训家庭CG的有效性知之甚少。干预是专为主动癌症治疗时期和直接过渡到治疗后的生存而设计 CG和患者最脆弱的时间。这个2组，前瞻性，随机的特定目的对照试验的对照试验与对照组相比评估CG干预的影响初级（焦虑）和次要（抑郁，健康相关的生活质量[HRQOL]和疲劳）结果；（2）衡量干预对患者预后的影响（HRQOL和中断治疗过程）和医疗保健利用成果（计划外的医院入院，计划外急诊室就诊和计划外使用静脉输液）；（3）确定CG自我效能感是否介导了干预的影响 CG焦虑；（4）确定患者疾病因素，护理需求以及患者和CG人群因素是否是否减轻干预与CG结果之间的关系；（5）比较医疗保健费用干预组和对照组之间的利用。我们将从大学医院招募180 cgs 案例综合癌症中心的Seidman癌症中心。干预涉及三个面对面的放射线治疗期间一对一会议，然后在处理后2周进行电话联系。数据将在基线，放射线处理结束时以及4和20周后处理。该分析将包括线性混合模型重复测量，中介和适度测试以及泊松回归方法。拟议的项目介绍了国家癌症研究所的癌症分部控制和人口科学的使命是改善向个人和家人提供护理受癌症的影响。研究结果将为翻译心理教育和在此干预措施中使用的模拟方法针对其他CG人群和临床环境。