Targeted, Tailored and Timely (T3) Symptom Management for Prostate Cancer

针对前列腺癌的针对性、定制性和及时 (T3) 症状管理

• 批准号: 7433343
• 负责人: SUSAN L BECK
• 金额: $ 14.29万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7433343
• 关键词: Address; Adherence; Adopted; Adverse effects; Aftercare; Age; Androgens; Anxiety; Arizona; Behavioral Research; Cancer Control; Cancer Survivor; Caring; Chronic; Cities; Classification; Clinical Trials; Communities; Computers; Consent; Counseling; Data; Data Collection; Diagnosis; Diarrhea; Disruption; Distress; Dysuria; Educational Materials; Educational process of instructing; Elderly; Emotional; Ensure; Exploratory/Developmental Grant; Fatigue; Fecal Incontinence; Goals; Grant; Hot flushes; Inflammation; Internet; Intervention; Intestines; Knowledge; Learning; Life; Localized; Mails; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Menopausal hot flushes; Mental Depression; Methods; Modeling; Numbers; Oncologic Nursing; Oncology Nurse; Outcome; Pain; Participant; Patient Preferences; Patients; Pilot Projects; Prostate; Prostate Cancer therapy; Provider; Quality of life; Radiation therapy; Randomized Clinical Trials; Recruitment Activity; Reporting; Research; Resources; Rural; Rural Community; Sampling; Self Care; Site; Sleep; Sleep disturbances; Sleeplessness; Structure; Subgroup; Survivors; Symptoms; Target Populations; Teaching Method; Telephone; Testing; Time; Transportation; Underserved Population; Utah; Work; Writing; base; cohort; concept; deprivation; design; desire; eligible participant; experience; health related quality of life; improved; innovation; man; men; novel; older men; preference; programs; response; rural area; size; social cognitive theory; sound; symposium; symptom management; theories; urinary

DESCRIPTION (provided by applicant): This exploratory study addresses the lack of systematic and structured symptom management targeted to men receiving radiation therapy ( androgen deprivation therapy) for prostate cancer. Because there is not a systematic and regular assessment of symptoms, they may go undetected. Patients may not report problems due to embarrassment, perceived busyness of providers, or lack of recognition that interventions are available to help. There is a lack of systematic educational programs to teach patients the self-care strategies that they can employ to manage their symptoms. As treatment ends, access to symptom management dwindles at the time when it is needed the most. This lack of access is compounded for older men who may have limited transportation and for those who reside in small towns or rural communities where resources are lacking. The long term goal of this research is to develop the most effective ways of improving quality of life for the increasing number of cancer survivors. The overall aims of this pilot study are (1) to test the feasibility and (2) to establish the initial efficacy and estimate the effect size of providing a systematic, structured, evidence- based symptom management intervention for older adult men with prostate cancer. T3 symptom management is an innovative approach which is targeted to the symptoms experienced by men with prostate cancer, tailored to the man's preferred learning method, and timed to when the symptoms are most likely to occur. The "T3" intervention provides a model to reach older adult prostate survivors, including men from rural communities, as they are completing radiation therapy. The targeted symptoms fatigue, insomnia, pain, urinary and bowel problems, hot flashes, depression and anxiety, This pilot study is an exploratory clinical trial which uses an experimental "patient preference" design with repeated measures in which two study groups will be compared in a 2:1 ratio: (1) the T3 symptom management intervention in which patients choose one of three preferred learning methods (n=72) or (2) usual care (n=36). One hundred and eight men (age 60 and older) who are completing radiation therapy ( androgen deprivation therapy) for prostate cancer and experiencing either a moderate level of symptom distress will be recruited to participate in the study from 2 settings in Utah and Arizona. It is anticipated that 40% of the participants (n=43) will reside in rural communities. All intervention and data collection methods will be delivered via computer (self-directed group only), mail, or telephone thus making them accessible to both rural and urban men with prostate cancer. One in 6 men will develop prostate cancer. This exploratory study addresses the lack of systematic and structured symptom management targeted to men receiving radiation therapy ( androgen deprivation therapy) for prostate cancer. Because there is not a systematic and regular assessment of symptoms, they may go undetected. Patients may not report problems due to embarrassment, perceived busyness of providers, or lack of recognition that interventions are available to help. This program can contribute to increasing knowledge about how to improve quality of life for men with prostate cancer by testing an innovative approach that targets troublesome symptoms and allows men to choose how they want to learn.

描述（由申请人提供）：这项探索性研究解决了针对接受前列腺癌放射治疗（雄激素剥夺疗法）的男性缺乏系统性和结构化症状管理的问题。由于没有对症状进行系统和定期的评估，它们可能不会被发现。患者可能会因为尴尬、认为服务提供者很忙或不认识到干预措施可以提供帮助而不会报告问题。缺乏系统的教育计划来教导患者可以用来控制症状的自我护理策略。随着治疗结束，在最需要的时候获得症状管理的机会就会减少。对于交通可能有限的老年男性以及居住在资源匮乏的小城镇或农村社区的人来说，这种缺乏机会的情况更加严重。这项研究的长期目标是开发最有效的方法来改善越来越多的癌症幸存者的生活质量。该试点研究的总体目标是（1）测试可行性，（2）确定为患有前列腺癌的老年男性提供系统的、结构化的、循证的症状管理干预措施的初步疗效并估计效果大小。 T3 症状管理是一种创新方法，针对前列腺癌男性所经历的症状，根据男性首选的学习方法量身定制，并选择症状最有可能出现的时间。 “T3”干预措施提供了一个模型来帮助老年前列腺幸存者，包括来自农村社区的男性，因为他们正在完成放射治疗。目标症状为疲劳、失眠、疼痛、泌尿和肠道问题、潮热、抑郁和焦虑。这项试点研究是一项探索性临床试验，采用实验性“患者偏好”设计和重复测量，两个研究组将以 2:1 的比例进行比较：(1) T3 症状管理干预，患者选择三种首选学习方法中的一种 (n=72) 或 (2) 常规护理 (n=36)。将招募 108 名正在完成前列腺癌放射治疗（雄激素剥夺疗法）并经历中度症状困扰的男性（60 岁及以上）从犹他州和亚利桑那州的 2 个地点参加这项研究。预计 40% 的参与者 (n=43) 将居住在农村社区。所有干预和数据收集方法都将通过计算机（仅限自我指导小组）、邮件或电话提供，从而使患有前列腺癌的农村和城市男性都能获得这些方法。六分之一的男性会患前列腺癌。这项探索性研究解决了针对接受前列腺癌放射治疗（雄激素剥夺疗法）的男性缺乏系统和结构化症状管理的问题。由于没有对症状进行系统和定期的评估，它们可能不会被发现。患者可能会因为尴尬、认为服务提供者很忙或不认识到干预措施可以提供帮助而不会报告问题。该计划可以通过测试针对麻烦症状并允许男性选择他们想要的学习方式的创新方法，有助于增加有关如何改善前列腺癌男性生活质量的知识。