CONTINUING CARE OF CANCER PATIENTS CONCRETE NEEDS

这项拟议的研究将调查癌症所面临的障碍。 阻碍获得具体服务的患者及其家属 使他们能够应对疾病的治疗和后果。 这项研究分为两个阶段：(一)描述性研究；(二) 干预计划。 在第一阶段，我们将确定已解决和未解决的 接受癌症门诊治疗的癌症患者的具体需求 复发的、转移性的、高度恶性的或不能切除的疾病。一个 将从200名门诊患者的横断面配额样本中挑选50名 四种疾病中的每一种：乳房、结肠、肺和妇科。这些 患者在疾病过程中处于不同的阶段，并在 它们的功能能力，使我们能够联系到 已解决和未解决的混凝土需要确定疾病的位置和阶段，并 性能状态。 数据将通过医院记录、患者和家属收集 采访。在确定已满足和未满足的需求时 患者和家属的评估和看法(主观 判决)将被考虑。需求得不到满足的原因将是 确定，以便现有的解决混凝土的机制 问题是可以评估的。 我们预计第一阶段的研究将证明患者缺乏 对可为他们提供的服务的了解是其 获得他们所需的援助。因此，在第二阶段，我们将 开发和实施由录像带组成的教育干预 演示文稿和小册子，然后讨论各种服务和 如何访问它们。 另一个配额样本为200名实验对象和200名对照对象 精选(50例乳腺癌、结肠癌、肺癌和妇科癌症患者 每组)。试验组将接受干预 在治疗的第六周和第八周之间。一个月后--他们的第三次 一个月的治疗--实验对象和一名家庭成员将 采访过了。对照受试者也将在他们结束时接受采访 第三个月的治疗。同样，满足和未满足的具体需求将是 使用在第一阶段开发的工具进行评估，两个小组将 进行比较，看看干预是否提高了患者和 家庭认识和预测他们的需要并解决他们的需要 有效地。

The proposed study will investigate the barriers confronted by cancer patients and their families that impede obtaining concrete services that enable them to cope with the treatment and consequences of the disease. The study has two stages: (I) a descriptive study, and (II) an intervention program. In Stage I we will determine the prevalence of both resolved and unresolved concrete needs of cancer outpatients who are receiving treatment for recurrent, metastatic, high grade, or unresectable disease. A cross-sectional quota sample of 200 outpatients will be selected, 50 from each of four disease sites: breast, colon, lung and gynecological. These patients will be at different stages in the disease process and vary in their functional capacities, permitting us to relate the prevalence of resolved and unresolved concrete needs to site and stage of disease and to performance status. Data will be collected through hospital records, patient and family interviews. In determining met and unmet needs both professional assessments and the perceptions of the patient and family (subjective judgments) will be considered. The reasons why needs go unmet will be ascertained, so that existing mechanisms for the resolution of concrete problems can be evaluated. We expect that the Stage I research will demonstrate that patients' lack of knowledge about services available to them is a major obstacle to their obtaining the assistance they need. Therefore, in Stage II, we will develop and implement an educational intervention consisting of a videotape presentation and booklet followed by a discussion on kinds of services and how to access them. Another quota sample of 200 experimental and 200 control subjects will be selected (50 patients with breast, colon, lung and gynecological cancers in each group). Those in the experimental group will receive the intervention between the sixth and eighth week of treatment. A month later--their third month of treatment--experimental subjects and a family member will be interviewed. Control subjects will also be interviewed at the end of their third month of treatment. Again, met and unmet concrete needs will be assessed, using the instruments developed in Stage I. The two groups will be compared to see if the intervention enhanced the ability of patients and families to recognize and anticipate their needs and to resolve them effectively.