Improving Pain Management in Cancer Care in Latinos

描述（由申请人提供）：本申请提议开发“HouseCalls Latino”，这是一个以西班牙语为基础的针对西班牙裔/拉丁裔癌症患者的科学和文化适当的评估和干预项目。《house secalls》拉丁文版将与英文版《house secalls》整合。这两个版本都使用最新的交互式语音应答（IVR）技术，以便患者可以在办公室就诊之间指示疼痛和症状水平，以及接收重要的教育和常见癌症相关问题的自我保健信息。管理应用程序还允许临床医生、研究人员和支持人员访问描述患者疼痛和症状水平随时间变化的可定制报告。该系统旨在解决日益增加的癌症门诊治疗问题，同时也帮助医疗保健提供者满足要求将疼痛和症状评估“常规化”的新指南。“家庭呼叫拉丁裔”系统的发展将使这些目标成为可能，即使西班牙/拉丁裔患者与非西班牙语提供者一起工作。第一阶段涉及系统核心评估模块的Alpha版本的开发和概念验证研究，以证明产品的可接受性。第二阶段将包括确认为HouseCalls Latino提出的所有评估模块的心理测量特性，以及完成教育和其他患者支持服务的制作和测试。尽管疼痛和其他令人痛苦的症状在癌症患者中极为普遍，但许多研究表明，这些严重影响生活质量的症状没有得到提供者的充分认识和记录。尽管JCAHO和其他监管机构要求疼痛“常规化”的新指南已经实施，但提供者正被大量浮出水面的疾病管理指南所淹没。对于经常面临文化和语言障碍的西班牙裔癌症患者来说，改善疼痛管理和姑息治疗的需求更为迫切。通过弥合医疗服务提供者和拉丁裔癌症患者之间的身体、文化和语言差距，同时使疼痛评估更准确、成本效益更高，HouseCalls拉丁裔系统旨在帮助解决这一重要问题。

DESCRIPTION (provided by applicant): This application proposes the development of HouseCalls Latino, a scientifically based and culturally appropriate assessment and intervention program in Spanish for Hispanics/Latinos with cancer. HouseCalls Latino will be integrated with an English version of HouseCalls. Both versions utilize the latest Interactive Voice Response (IVR) technology so that patients can indicate pain and symptom levels in between office visits, as well as receive critical educational and self-care information for common cancer-related problems. An administrative application also allows clinicians, researchers, and support staff to access customizable reports depicting patients' pain and symptom levels over time. The system is designed to address the increasing treatment of cancer on an outpatient basis, while also helping healthcare providers meet emerging guidelines that call for the "routinization" of pain and symptom assessments. The development of the HouseCalls Latino system will make these goals possible even when Hispanic/Latino patients are working with non-Spanish speaking providers. Phase I involved development of Alpha versions of the system's core assessment modules and proof of concept research to demonstrate product acceptability. Phase II will involve confirmation of the psychometric properties of all assessment modules proposed for HouseCalls Latino, as well as production and testing of completed educational and other patient support services. Even though pain and other distressing symptoms are extremely widespread among cancer patients, numerous studies have shown that these symptoms, significantly affecting quality of life, are insufficiently recognized and poorly documented by providers. Although new guidelines by JCAHO and other regulatory agencies requiring the 'routinization' of pain have been implemented, providers are becoming overwhelmed by the multitude of disease management guidelines that are surfacing. This need for improved pain management and palliative care is even more urgent among Hispanic cancer patients, who often face cultural and linguistic barriers. By bridging the physical, cultural, and linguistic gaps between health care providers and Latino cancer patients and simultaneously making pain assessments more accurate and cost-effective, the HouseCalls Latino system is designed to help address this important problem.