Internet-Based Cancer Symptom Management: WRITE Symptoms

描述（由申请人提供）：许多癌症患者会出现多种并发症状，严重损害功能和生活质量。试图管理多种症状的过程可能会让患者不堪重负。最近开发了一种创新的患者教育方法，该方法应有助于管理多种疾病的过程9。该提案代表了将代表性方法应用于新的交付模式（从面对面访谈到通过安全的互联网消息服务进行通信）和更复杂的患者护理情况（从管理单个预定症状到多个患者选择的症状）的过程的第一阶段。我们称之为缓解症状的书面表征干预，或写症状。 这项与国家卵巢癌联盟（NOCC）合作进行的试点研究的具体目的是对复发性卵巢癌妇女的WRITE症状进行初步评估（可行性，可接受性和初步疗效）。受试者将是通过邮寄邀请和NOCC网站上的广告招募的90名经历两种或更多种与卵巢癌相关的令人烦恼的症状的女性。妇女将被随机分配到2个条件之一：1）一个完整的基线评估，写症状干预组;和2）一个完整的基线评估，修改后的等待名单对照组。WRITE症状将通过位于NOCC网站上的安全消息服务提供。所有受试者将在基线以及5周和9周后完成症状表征、症状对生活活动的干扰和生活质量的测量。将在招募期间、整个研究期间和受试者完成研究后进行可行性和可接受性评估。如果WRITE症状通过了可行性、可接受性和有效性的初步评价，则将使用从该试点研究中获得的知识来计划随机对照试验资助申请（R01），以确定干预措施的有效性以及干预措施发挥作用的潜在机制。

DESCRIPTION (provided by applicant): Many individuals with cancer experience multiple, co-occurring symptoms that drastically impair functioning and quality of life. The process of trying to manage multiple symptoms can be overwhelming to patients. An innovative approach to patient education has recently been developed that should facilitate the process of managing multiple symptoms9. This proposal represents the first phase in the process of applying the representational approach to a new delivery mode (from in-person interviews to correspondence via secure internet messaging services) and to a more complex patient care situation (from management of a single, pre-determined symptom to multiple, patient-selected symptoms). We refer to this as a Written Representational intervention To Ease Symptoms, or WRITE symptoms. The specific aims of this pilot study, conducted in collaboration with the National Ovarian Cancer Coalition (NOCC), are to conduct preliminary evaluations (feasibility, acceptability, and initial efficacy) of WRITE symptoms with a sample of women with recurrent ovarian cancer. Subjects will be 90 women experiencing two or more bothersome symptoms associated with ovarian cancer recruited via mailed invitations and advertisements on the NOCC website. Women will be randomly assigned to one of 2 conditions: 1) a full baseline assessment, WRITE symptoms intervention group; and 2) a full baseline assessment, modified wait-list control group. WRITE symptoms will be delivered via secure messaging services situated on the NOCC website. Measures of symptom representations, symptom interference with life activities and quality of life will be completed by all subjects at baseline and 5 and 9 weeks later. Assessment of feasibility and acceptability will be conducted during recruitment, throughout the study period, and after subjects have completed the study. Should WRITE symptoms pass initial evaluations of feasibility, acceptability, and efficacy, knowledge gained from this pilot study will be used to plan a randomized controlled trial grant application (R01) to determine the efficacy of the intervention and the potential mechanism(s) through which the intervention has its effect.