Caregivers' Strengths-Skills:Managing Older Cancer Patients' Symptoms

描述(由申请人提供)：我们建议实施并评估一项针对家庭照顾者的短期问题解决技能培训计划的效果，以降低老年(60岁以上)癌症治疗后患者的收入。干预的目标是让家庭照顾者掌握解决问题的技能和知识，为他们提供更适应的方式来照顾他们的老年亲属在癌症生存期可能遇到的任何症状。通过关注家庭在治疗后的姑息治疗中的潜在作用，我们提出，我们将能够通过促进症状识别、改善症状控制、与卫生专业人员的宣传以及坚持症状管理选择，来影响患者与健康相关的生活质量。已完成积极治疗的老年癌症患者的家庭照顾者将从社区/移民卫生中心(C/MHC)获得。护理人员和患者将接受为期10个月的跟踪调查。具体目标是： (1)提供与症状管理(“问题解决”)有关的简短问题解决培训计划，以提高家庭照顾者的照顾者技能(即自我效能感、解决社会问题和沟通)，以帮助治疗后的老年癌症患者。 (2)与参加照顾者支持小组(“支持”)相比，评估解决问题在提高照顾者技能方面的有效性：(A)评估被分配到解决问题条件或支持条件的照顾者报告的照顾者技能的短期和长期变化；以及(B)比较照顾者在解决问题条件下报告的变化与处于支持条件的照顾者报告的变化； (3)评估护理者技能的变化对以下方面的影响：(A)患者症状和身体功能、抑郁症状、焦虑、生活质量、对护理的看法和满意度(“患者结果”)的变化；(B)护理者抑郁症状、焦虑、生活质量、对患者护理的看法和满意度(“护理者结果”)的变化。 (4)向参加的社区/母婴健康中心和服务于这些人群的其他社区/母婴健康中心传播有关缓解和症状控制方面的家庭培训的信息，条件是展示有益的方案成果。

DESCRIPTION (provided by applicant): We propose to implement and evaluate the efficacy of a short-term problem-solving skills training program for familial caregivers to lower income older (60+) post-treatment cancer patients. The goal of the intervention is to equip family caregivers with problem-solving skills and knowledge that will provide them with a more adaptive means of attending to any symptoms their elderly relative may be experience during the cancer survivorship period. By focusing attention on families' potential role in palliative care efforts during the post-treatment period, we propose that we will be able to impact patients' health related quality of life, by fostering enhanced symptom recognition, improved symptom control, advocacy with health professionals, and adherence to symptom management options. Familial caregivers to older cancer patients who have completed active treatment will be accrued from Community/Migrant Health Centers (C/MHCs). Caregivers and patients will be followed for ten months. The specific aims are to: (1) Deliver a brief problem-solving training program with regard to symptom management ("Problem-solving") to enhance caregiver skills (i.e., perceived self-efficacy, social problem-solving and communication) of familial caregivers to older post-treatment cancer patients. (2) Evaluate the efficacy of problem-solving in enhancing caregiver skills, relative to participating in a caregiver support group ("Support"): (a) Assess short- and long-term change in caregiver skills reported by caregivers assigned to either the Problem-solving condition or the Support condition; and, (b) Compare change reported by caregivers in the Problem-solving condition, relative to reports by those in the Support condition; (3) Assess the impact of change in caregiver skills on: (a) Change in patients' symptomology and physical functioning, depressive symptomology, anxiety, quality of life, perceptions of and satisfaction with care ("patient outcomes"); (b) Change in caregivers' depressive symptomology, anxiety, quality of life, perceptions of and satisfaction with patient care ("caregiver outcomes"). (4) Disseminate information that informs family training in palliation and symptom control to participating C/MHCs and other C/MHCs serving these populations, contingent on demonstrating beneficial program outcomes.