"Beyond Cancer":Fostering transitions post-treatment

描述(由申请人提供)：在过去的20年里，所有癌症部位的相对5年存活率都有所增加。更多的患者正在完成治疗，并进入应对疾病的治疗后早期阶段。治疗阶段的结束可能会在情感和身体上造成严重损害。这些问题通常得不到卫生保健提供者的认可和解决，因此，有一些长期幸存者永远不会恢复正常生活。大多数现有的干预措施使用面对面的形式，因此仅限于有能力到达干预地点的个人。拟议的分两个阶段进行的试点研究旨在修改并评估修改后的干预战略的可接受性和可行性，该战略旨在促进恢复生产性生活和改善生活质量。拟议的研究通过以下方式解决了以前确定的差距和局限性：使用两种中性肿瘤研究男性和女性癌症患者；纳入患者和照顾者的观点；通过阻止性别来控制潜在的性别差异；在治疗后的前3个月提供干预；使用使干预广泛可用的形式[录像带、手册、电话会议]。具体来说，这项建议解决了以下问题：(1)现有的认知行为干预计划需要如何调整，以便在完成结直肠癌、霍奇金病或非霍奇金淋巴瘤患者及其主要照顾者的治疗后的前3个月内使用？(2)患者和照顾者在完成治疗后的前3个月对修改后的认知行为干预计划的接受度如何？(3)干预对参与者报告的感知控制、应对、感知社会支持和生活质量有什么影响？其影响有多大？在第一阶段，我们将进行描述性研究，以收集对现有干预措施的反馈。参与者将收到现有的干预录像带和练习册以及评估问题。在审查这些材料之后，将进行一个焦点小组，以获得具体的反馈。在第二阶段，将进行随机临床试验，以评估改进的干预措施的可接受性/可行性，并确定对生活质量和其他相关结果的影响。

DESCRIPTION (provided by applicant): The relative 5-year survival rate for all cancer sites has increased over the past 20 years. More patients are completing treatment and entering the early post-treatment phase of coping with their illness. The end of treatment phase may be emotionally and physically crippling. These issues are typically not recognized and addressed by health care providers, and therefore, there are long-term survivors who never resume a 'normal' life. Most existing interventions use a face-to-face format, thus limiting their use to individuals who have the ability to 'get to' the intervention site. The proposed two-stage pilot study seeks to modify and then evaluate the acceptability and feasibility of the modified intervention strategy designed to enhance the return to a productive existence and improve quality of life. The proposed study addresses the previously identified gaps and limitations by: studying men and women cancer patients using two tumors that are gender neutral; incorporating the patient's and caregiver's perspectives; controlling for potential gender differences by blocking on gender; delivering the intervention during the first 3 months post-treatment; and using a format that makes the intervention widely accessible [videotapes, a manual, telephone conference calls]. In particular, this proposal addresses the following questions: (1) How does an existing cognitive behavioral intervention program need to be adapted for use during the first 3 months following treatment with patients completing treatment for colorectal cancer, Hodgkin's disease, or Non-Hodgkin's lymphoma and their primary caregivers?; (2) How acceptable is the modified cognitive behavioral intervention program to patients and caregivers during the first 3 months after completing treatment?; and (3) What effects does the intervention have on the perceived control, coping, perceived social support, and quality of life reported by the participants? How sizable are the effects? In the first stage, we will conduct a descriptive study to elicit feedback about the existing intervention. Participants will be given the existing intervention videotapes and workbook along with evaluation questions. After reviewing the materials, a focus group to elicit specific feedback will be conducted. For Stage Two, a randomized clinical trial will be conducted to evaluate the acceptability/feasibility of the modified intervention as well as to determine the effects on quality of life and other related outcomes.