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

这项研究的目的是测试 干预措施，不同的责任地点（LR）的自我- 护理决定（患者或医疗保健提供者）使用自我- 癌症患者的护理行为和随后的健康结果 在门诊接受化疗的患者。 个体差异变量的影响， 卫生保健行为控制（BC），以及各种人口统计学 还将研究变量。 关于LR的具体假设， BC对应对结果（消极情绪和破坏）的影响 在日常活动中），发病率和自我护理的利用率 行为将受到考验。 样本将由162名患者组成 开始门诊化疗。 患者将被随机分配到三组之一，（即， 常规护理控制，LR=患者或LR=专业责任）。 所有受试者将接受标准化的信息 干预 两个实验组将听一盘磁带 记录的信息集中在对自我决定的责任上， 患者或专业人员的护理，也将获得 护士打来的后续电话 成果数据 将使用缩短的情绪概况来收集应对方式 国家和塞尔比的措施中断在日常活动中 在前两个治疗周期中的每个周期内进行三次， 在治疗开始后6个月。 副作用 强度和痛苦将在同一时间测量， 应对的结果。 自我护理的使用和功效数据 行为将在第二和第九天收集， 前两个治疗周期。 应对策略和一般 治疗后9天将采取预防措施 第一和第二治疗周期。 重复测量ANCOVA 随后的对比分析将用于测试 假设 描述性和相关性分析将用于 确定副作用的模式和自我护理的使用/功效 行为，并确定中介变量，可以解释 干预的效果。

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.