FAMILY HOME CARE FOR CANCER--A COMMUNITY BASED MODEL

老年人的癌症发病率正在上升， 了解持续的癌症护理。 癌症已经从急性 迅速消退的疾病，通常是死亡，转为慢性疾病， 长期治疗可延长生存时间。 在老年人中， 可能会在功能受限的情况下度过。 这 研究提出描述一种新的癌症诊断，最初和 继续治疗，引发或增加自我护理的限制， 老年人活动能力、认知症状与心理健康 患者以及这些变量如何影响参与，反应和 家庭照顾者的心理健康。 本研究探讨了 老年人癌症的临床病程及治疗 援助的需要，家庭的参与， 和非正式的成本提供这种照顾。 这个轨迹始于 在治疗前30天对患者功能进行回顾性评估 住院，获得分期数据，初始治疗，并继续 在6岁、12岁、24岁和52岁时观察患者及其护理人员 周 将按顺序累计1235名患者 为了确保大约800例（200例前列腺，乳腺， 结肠直肠癌和肺癌）将在观察结束时保留。 这项研究建立在我们目前的工作和扩展知识：l） 检查年龄，合并症，癌症部位，疾病阶段， 在癌症诊断之前测量的功能，涉及 治疗的侵略性和随后的自我护理限制， 活动性、运动性和认知; 2）与年龄、合并症、癌症相关 地点、治疗和运作，以使家庭参与照料， 他们的反应，和心理健康; 3）如何事件的情况下，四种癌症 站点及其处理与正式系统成本有关， 照顾这些人的家庭承担的非正式费用。 本申请中提出的研究是一个必不可少的"下一步"， 为了针对患者特征、癌症部位和 治疗变量和管理策略的设计成本 有效的干预措施，将改善功能的结果， 由家人在家照顾的年老癌症病人。

The incidence of cancer is increasing among the elderly and little is known about continuing cancer care. Cancer has shifted from an acute disease with prompt resolution, usually death, to a chronic disease where long-term treatment increases survival time. Among the elderly, a portion of that survival may be spent with limitations in functioning. This research proposes to describe how a new cancer diagnosis, initial and continuing treatment, initiates or adds to limitations in self care, mobility, continence, cognition symptoms, and mental health of elderly patients and how these variables affect the involvement, reactions and mental health of family caregivers. This research examines the impact of the clinical course of cancer and its treatment upon elderly patients' needs for assistance, the involvement of their families, and the formal and informal costs of providing this care. This trajectory begins with a retrospective assessment of patient functioning 30 days prior to hospitalization, obtains staging data, initial treatment, and continues with observations of patients and their caregivers at 6, 12, 24, and 52 weeks. Twelve hundred and thirty-five patients will be accrued in order to assure that approximately 800 cases (200 cases of prostate, breast, colo-rectal, and lung cancer) will be retained at the end observation. This study builds upon our current work and extends knowledge by: l) examining how age, comorbidity, cancer site, stage of disease, and function, measured prior to the cancer diagnosis, relates to the aggressiveness of treatment and to subsequent limitations in self care, mobility, continence and cognition; 2) relating age, comorbidity, cancer site, treatment and functioning to the involvement of families in caring, their reactions, and mental health; 3) how incident cases of four cancer sites and their treatment are related to the formal system costs and informal costs born by families caring for these persons. The research proposed in this application is an essential "next step" in order to target the cluster of patient characteristics, cancer site and treatment variables, and management strategies for the design of cost effective interventions that will improve the functional outcomes for elderly cancer patients cared for by their families at home.