CANCER PATIENTS TREATMENT AND CONCRETE SERVICE NEEDS

有证据表明，癌症患者在以下情况下会产生对具体服务的需求 他们的疾病复发、进展和/或具有潜在毒性的抗肿瘤药物 治疗开始了。这一过程可以立即开始，也可以长期开始。 在最初诊断时间之后。具体需求可以分为以下几类 三个小组：个人护理；工具援助；和帮助 管理问题。拟议的项目寻求进行一项 使用待开发的通用工具进行全面需求评估 与国家癌症研究所合作，收治500名患者 在以医院为基础的肿瘤内科诊所接受治疗或从 参加活动的社区肿瘤学家。这些调查数据的分析将是 用来检验这样一种假设，即有未满足混凝土风险的患者 服务需求是指那些有功能缺陷和支持能力差的人。 调查结束后，我们将启动一项前瞻性随机临床试验。 短期病例管理和病人教育的效果评价 针对高危癌症患者的计划。总共有250名患者从 诊所和私人肿瘤学家的工作量将是随机的，其中一半将 接受最长三个月的干预。实验前/实验后设计 将在随机化后3个月和6个月评估以下结果； 未满足的需求、治疗依从性、残疾天数、服务利用率、 和服务成本。

Evidence suggests cancer patients develop needs for concrete services when their disease recurs, advances, and/or when potentially toxic anti-tumor treatment is initiated. This process can begin either immediately or long after the time of initial diagnosis. Concrete needs can be classified into three groups: personal care; instrumental assistance; and help with administrative problems. The proposed project seeks to conduct a comprehensive needs assessment using a common instrument to be developed jointly with the National Cancer Institute of five hundred (500) patients undergoing treatment in a hospital-based medical oncology clinic or from participating community oncologists. Analyses of these survey data will be used to test the hypothesis that patients at risk of having unmet concrete service needs are those with functional deficits and with poor supports. Following the survey, we will initiate a prospective randomized clinical trial of the effects of a short-term case management and patient education program on at-risk cancer patients. A total of 250 patients drawn from clinic and private oncologists' caseloads will be randomized, and half will receive up to a three-month intervention. A pre/post-experimental design will measure the following outcomes at 3 and 6 months post-randomization; unmet needs, treatment compliance, disability days, service utilization, and service cost.