A Multimedia Self-Management Intervention to Prepare Family Caregivers and Patients for Lung Cancer Surgery

多媒体自我管理干预措施，帮助家庭护理人员和患者为肺癌手术做好准备

• 批准号: 10472023
• 负责人: JAE KIM
• 金额: $ 71.75万
• 依托单位: BECKMAN RESEARCH INSTITUTE/CITY OF HOPE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-18 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10472023
• 关键词: Acute; Address; Age; American; American College of Surgeons; Area; Cancer Patient; Cancer Science; Cardiovascular system; Caregiver Burden; Caregiver research; Caregiver support; Caregivers; Caring; Chronic; Chronic Care; Clinical Research; Complex; Control Groups; Data; Diagnosis; Discipline of Nursing; Early Diagnosis; Early treatment; Emergency department visit; Employment Status; Environment; Family; Family Caregiver; Fatigue; Goals; Health; Healthcare; Home; Home Nursing Care; Hospitalization; Hospitals; Individual; Institute of Medicine (U.S.); Intervention; Interview; Knowledge; Lung; Malignant Neoplasms; Malignant neoplasm of lung; Marital Status; Mediator of activation protein; Modeling; Morbidity - disease rate; Multimedia; National Cancer Institute; Nurses; Operative Surgical Procedures; Outcome; Pain; Participant; Patient-Focused Outcomes; Patients; Physical Function; Population; Postoperative Period; Problem Solving; Quality of Care; Quality of life; Readiness; Recovery; Research; Research Priority; Resources; Risk; Role; Self Care; Self Efficacy; Self Management; Services; Social Work; Specific qualifier value; Surgeon; Telephone; Testing; The Sun; Thoracic Surgical Procedures; Time; Work; aging population; attentional control; base; cancer care; cancer surgery; care giving burden; caregiver interventions; caregiving; comorbidity; comparison intervention; design; economic cost; efficacy testing; experience; family support; group intervention; handbook; health care service utilization; hospital readmission; human old age (65+); improved; innovation; member; neoplasm resource; older patient; postoperative recovery; psychological distress; pulmonary function; randomized trial; screening; sex; skills; social; standard of care; urgent care

Project Summary - The overall purpose of this proposal is to test the efficacy of a Multimedia Self- Management (MSM) Intervention to prepare 160 caregiver-patient dyads for lung cancer surgery. This research is critical because lung cancer patients are discharged from the hospital earlier after surgery despite an aging population (age 65 and older) that suffers from greater co-morbidities and decreased quality of life (QOL). As a result, the bulk of the caregiving burden after surgery has fallen on family caregivers (FCGs). This randomized trial is designed to integrate the fields of nursing, FCG research and thoracic surgery in order to develop a dyadic model of care that can become a standard of care in cancer surgery. This multiple PD/PI proposal leverages the clinical and research expertise of the two PIs (Sun: nursing, FCG research; Kim: surgery) by testing the MSM Intervention to impact key FCG and patient variables that influence their quality of life and the quality of care after lung cancer surgery. Based on the Chronic Care Self-Management Model (CCM), the MSM Intervention is a nurse-led, caregiver-based, multimedia care model for lung cancer surgery. Its primary focus is 1) to provide one-on-one coaching with lung cancer FCGs on post-operative caregiving and managing their QOL needs; and 2) to target FCG-patient dyadic knowledge and skills in preparing for surgery and post-operative recovery activities. The intervention includes video, handbook, and nurse phone calls after hospital discharge. It is administered at five time points: before surgery, during hospitalization, and at 3 time points (day 2, day 7, and 2 months) after discharge. We will test the efficacy of the MSM Intervention using a randomized trial of attention control group versus an intervention group to pursue the following specific aims: Specific Aim 1: Test the effects of the MSM Intervention on FCG outcomes and cancer support services use; Specific Aim 2: Test the effects of the MSM Intervention on patient outcomes and healthcare resource use; Specific Aim 3: Test the effects of the MSM Intervention on outcome mediators (activation, self-efficacy, knowledge); Exploratory Aim 1: Explore moderators (age, sex, marital status, caregiver relationship to patient, caregiver employment status, co-morbidities) of FCG and patient outcomes and reciprocal relationships; Exploratory Aim 2: Determine, through exit interviews, participant's experience with the MSM intervention. This proposal is innovative because it merges the science of cancer caregiving, self- management, and thoracic surgery in order to improve the care of cancer surgery patients. This proposal is significant because the outcomes which are being studied have been cited to be of critical importance to FCGs, patients, surgeons, the National Cancer Institute, and the Institute of Medicine; these outcomes include psychological distress, caregiver burden, quality of life, and healthcare resource use. The long-term goal is to prove that the CCM can be applied to patients with lung cancer and their FCGs to better prepare them for surgery, improve postoperative outcomes, and optimize healthcare resource/cancer support services use.

项目摘要-本提案的总体目的是测试多媒体自我- 管理（男男性接触）干预准备160例患者配对肺癌手术。这 研究是至关重要的，因为肺癌患者在手术后较早出院， 患有更多合并症和生活质量下降的老龄化人群（65岁及以上） （QOL）。因此，手术后的大部分负担都落在了家庭照顾者（FCG）身上。这 随机试验旨在整合护理，FCG研究和胸外科领域，以 发展一种可以成为癌症手术护理标准的二元护理模式。这种多个PD/PI 该提案利用了两名PI的临床和研究专业知识（Sun：护理，FCG研究; Kim： 通过测试MSM干预措施来影响关键的FCG和影响其质量的患者变量， 生活和护理质量的肺癌手术后。基于慢性病护理自我管理模式 (CCM)MSM干预是一种以护士为主导、以护士为基础的多媒体肺癌手术护理模式。 其主要重点是：1）提供一对一的肺癌术后随访指导， 管理他们的QOL需求;和2）在准备手术时瞄准FCG患者的二元知识和技能 和术后恢复活动。干预包括视频，手册和护士电话后， 出院在5个时间点给药：术前、住院期间和3个时间点 出院后的时间点（第2天、第7天和2个月）。我们将测试MSM干预的有效性，使用 注意力控制组与干预组的随机试验，以追求以下特定目标： 具体目标1：测试MSM干预对FCG结果和癌症支持服务使用的影响; 具体目标2：测试MSM干预对患者结局和医疗资源使用的影响; 具体目标3：测试MSM干预对结果介质（激活，自我效能， 探索性目标1：探索调节因素（年龄、性别、婚姻状况、照顾者与 患者、护理人员就业状况、合并症）FCG和患者结局以及相互关系 探索性目标2：通过离职面谈确定参与者与MSM的经历 干预这个建议是创新的，因为它融合了癌症的科学，自我， 管理，以提高对胸外科癌症手术患者的护理。这项建议是 重要，因为正在研究的成果被认为对 FCG、患者、外科医生、国家癌症研究所和医学研究所;这些结果包括 心理困扰、照顾者负担、生活质量和医疗资源使用。长期目标是 证明CCM可以应用于肺癌患者及其FCG，以更好地为他们做好准备 手术，改善术后结果，优化医疗资源/癌症支持服务使用。