INFLUENCING SELF-CARE--FOCUSED REVIEW AND FOLLOW-UP

这项拟议的研究的目的是测试 自我责任点(LR)不同的干预措施 护理决策(患者或医疗保健提供者)关于使用自我 癌症患者的护理行为与随后的健康结局 在门诊护理环境中接受化疗的患者。 个体差异变量的影响，渴望 卫生保健的行为控制(BC)，以及各种人口统计学 变量也将被研究。关于LR和LR的具体假设 BC对应对结果(消极情绪和干扰)的影响 在日常活动中)、自理的发病率和利用 将对行为进行测试。样本将包括162名患者 开始门诊化疗。 患者将被随机分配到三组中的一组(即， 日常护理控制，LR=患者或LR=专业责任)。 所有受试者都将收到标准化的信息 干预。两个实验组将听一盘磁带 录制的信息侧重于对有关自我决策的责任 对患者或专业人员的护理，也将收到 护士打来的后续电话。关于结果的数据 将使用缩短的情绪档案收集应对方式 国家和塞尔比对日常活动中断的衡量 在前两个治疗周期的每个周期中进行三次 6个月后再次开始治疗。副作用 烈度和遇险将在同一时间测量 应对的结果。关于自我护理的使用和效果的数据 将在第二天和第九天收集行为 前两个治疗周期。应对策略和一般策略的使用 预防策略将在治疗后9天采取措施 用于治疗周期一和周期二。重复测量ANCOVA 与随后的对比分析将被用来测试 假设。将使用描述性和相关性分析来 确定自我护理的副作用和使用/效果的模式 并找出可能解释 干预措施的效果。

The purpose of the proposed research is to test the effects of interventions that vary on locus of responsibility (LR) for self- care decisions (patient or health care provider) on the use of self- care behaviors and subsequent health outcomes among cancer patients receiving chemotherapy in the ambulatory care setting. The effects of an individual difference variable, desire for behavioral control of health care (BC), and various demographic variables will also be studied. Specific hypotheses about LR and BC effects on outcomes of coping (negative mood and disruption in day-to-day activities), morbidity, and utilization of self-care behaviors will be tested. The sample will consists of 162 patients beginning chemotherapy treatment on an outpatient basis. Patients will be randomly assigned to one of three groups, (i.e., usual care control, LR=patient or LR=professional responsibility). All subjects will receive a standardized informational intervention. The two experimental groups will listen to a tape recorded message focusing responsibility for decisions about self- care on either the patient or the professional and also will receive a follow-up telephone call from the nurse. Data on the outcomes of coping will be collected using the shortened Profile of Mood States and Selby's measure of disruption in day-to-day activity three times during each of the first two treatment cycles and again six months after the beginning of treatment. Side effect intensity and distress will be measured at the same times as the outcomes of coping. Data on use and efficacy of self-care behaviors will be collected during the second and ninth days of the first two treatment cycles. Coping strategies and use of general preventive strategies will be measure nine days after treatment for treatment cycles one and two. Repeated measures ANCOVA with subsequent contrast analyses will be used to test the hypotheses. Descriptive and correlational analysis will be used to identify the patterns of side effects and use/efficacy of self-care behaviors and to identify mediating variables that may explain the effects of the interventions.