Evaluating Survivorship Care Planning in Colorectal Cancer

评估结直肠癌的生存护理计划

• 批准号: 7894819
• 负责人: Brian M. Rivers
• 金额: $ 8.35万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-17 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7894819
• 关键词: Accounting; Address; Adopted; Adverse effects; American; Attitude; Awareness; Behavior; Cancer Patient; Cancer Survivor; Carcinoembryonic Antigen; Caring; Characteristics; Clinical; Colorectal Cancer; Communication; Detection; Development; Diagnosis; Disease; Effectiveness; Ensure; Evaluation; Female; Future; Goals; Guidelines; Health; Health Personnel; Health Promotion; Incidence; Institute of Medicine (U.S.); Interview; Investigation; Knowledge; Late Effects; Learning; Length; Longitudinal Studies; Malignant Neoplasms; Measures; Mental Depression; Methodology; Monitor; Monitoring for Recurrence; Obesity; One-Step dentin bonding system; Outcome; Outcome Measure; Patient Care Planning; Patient Education; Patients; Physicians; Pilot Projects; Population; Prevention; Probability; Provider; Public Health; Qualitative Research; Quality of Care; Randomized; Recommendation; Reporting; Research; Risk; Risk Factors; Screening for cancer; Second Primary Cancers; Second Primary Neoplasms; Self Efficacy; Site; Solutions; Staging; Survivors; Testing; Time; TimeLine; Toxic effect; Waiting Lists; Weight; Work; Writing; active method; aging population; base; cancer care; cancer diagnosis; cancer recurrence; cancer therapy; cancer type; cohort; design; experience; follow-up; improved; male; medically underserved population; satisfaction; standard care; success; survivorship

With the growing cohort of cancer survivors now numbering 11 million Americans, appropriate follow-up care is pivotal to their ongoing long-term health. Despite guidelines regarding surveillance for recurrence and monitoring of toxicities and late effects, cancer survivors are often lost to follow-up, resulting in fragmented, inadequate care. Recently there has been increased emphasis on the gap between the needs of cancer survivors and current practice. Survivorship care planning, specifically provision of a treatment summary and survivorship care plan (TS/SCP) to patients completing active treatment, has been proffered by the Institute of Medicine as one solution to this growing public health issue. The goals of TS/SCPs are: 1) enhance patient knowledge of their cancer care, and extant health risks; 2) increase patient awareness of and confidence in obtaining requisite follow-up care; 3) communication and coordination of care between patients and providers and 4) impact patients' length and quality of survival via a focus on health promotion and prevention. Treatment summaries and survivorship care plans have yet to be widely adopted or empirically investigated despite their foreseeable advantages, due in part to a lack of methodology and outcome measures to assess their potential benefits. Thus, development and pilot of methodology targeting detection of the benefits of implementation of treatment summary and survivorship care plans is a crucial first step, one that may have implications for understanding longer-term outcomes. The proposed project will; 1) develop methodology to assess potential benefits of treatment summaries and survivorship care plans; and 2) pilot the developed outcome measures with cancer patients transitioning to off-treatment. In Study 1, qualitative research will be conducted to formulate and refine outcome measures via interviews with diverse stakeholders (health care providers and colorectal cancer survivors). The outcome measures identified and refined in Study 1 will then be used in Study 2 to evaluate the benefits of providing TS/SCPs to colorectal cancer patients finishing active treatment and transitioning to off-treatment status. Study 2 will assess the ability of the outcome measures to detect the anticipated benefits of treatment summaries and survivorship care plans. In a randomized wait-list control design, patients who receive written treatment summaries and survivorship care plans will be compared to patients who did not receive written treatment summaries and survivorship care plans on outcome measures. Thus, this study is expected to yield measures and methodology to empirically assess the potential benefits of treatment summaries and survivorship care plans. Findings from this study will be used together in a future randomized longitudinal study to more definitively evaluate the impact of treatment summaries and survivorship care plans for patients with colorectal cancer and other common types of cancer.

随着癌症幸存者人数的增加，现在有1100万美国人，适当的后续护理对他们持续的长期健康至关重要。尽管有监测复发和监测毒副作用和后遗症的指导方针，但癌症幸存者往往失去了后续行动，导致零散的、不充分的护理。最近，人们越来越重视癌症幸存者的需求与目前做法之间的差距。生存护理计划，特别是为完成积极治疗的患者提供治疗总结和生存护理计划(TS/SCP)，已由医学研究所作为这一日益增长的公共卫生问题的解决方案之一。TS/SCP的目标是：1)增强患者对其癌症护理和现有健康风险的了解；2)提高患者对获得必要的后续护理的认识和信心；3)患者与提供者之间的沟通和协调；4)通过关注健康促进和预防来影响患者的生存时间和质量。治疗总结和生存护理计划尚未得到广泛采用或经验性调查，尽管它们具有可预见的优势，部分原因是缺乏评估其潜在益处的方法和结果衡量标准。因此，以检测实施治疗总结和生存护理计划的益处为目标的方法学的开发和试点是关键的第一步，这可能对了解长期结果具有影响。拟议的项目将：1)制定评估治疗总结和生存护理计划的潜在益处的方法；2)试行癌症患者过渡到非治疗阶段的结果衡量标准。在研究1中，将进行定性研究，通过采访不同的利益相关者(医疗保健提供者和结直肠癌幸存者)来制定和完善结果衡量标准。在研究1中确定和改进的结果衡量标准将在研究2中使用，以评估向完成积极治疗并过渡到非治疗状态的结直肠癌患者提供TS/SCP的好处。研究2将评估结果措施的能力，以发现治疗总结和生存护理计划的预期益处。在随机等待名单对照设计中，接受书面治疗总结和生存护理计划的患者将与没有接受书面治疗总结和生存护理计划的患者在结果衡量方面进行比较。因此，这项研究有望产生对治疗总结和生存护理计划的潜在益处进行经验性评估的措施和方法。这项研究的结果将一起用于未来的随机纵向研究，以更明确地评估治疗总结和生存护理计划对结直肠癌和其他常见类型癌症患者的影响。