Internet-Based Cancer Symptom Management: WRITE Symptoms

描述(由申请者提供)：许多癌症患者都有多种共同出现的症状，这些症状严重损害了患者的功能和生活质量。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，应该有助于管理多种症状9的过程。这项提议是将代表性办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信息服务通信)和更复杂的病人护理情况(从管理单一的预先确定的症状到多个病人选择的症状)过程的第一阶段。我们把这称为缓解症状的书面代表性干预，或写下症状。 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卵巢癌女性样本进行书面症状的初步评估(可行性、可接受性和初步疗效)。受试者将是90名经历两种或两种以上与卵巢癌相关的烦人症状的女性，这些女性是通过NOCC网站上的邮寄邀请和广告招募的。女性将被随机分配到2种情况之一：1)完整的基线评估，写下症状干预组；以及2)完整的基线评估，修改的等待名单对照组。书写症状将通过NOCC网站上的安全消息服务提供。所有受试者将在基线、5周和9周后完成症状表现、对生活活动的症状干扰和生活质量的测量。在招募过程中、整个研究期间以及受试者完成研究后，将进行可行性和可接受性评估。如果写出的症状通过了可行性、可接受性和有效性的初步评估，从这项试点研究中获得的知识将被用于计划随机对照试验拨款申请(R01)，以确定干预的有效性和干预产生效果的潜在机制(S)。

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.