A Web-based Multimedia Intervention for Head and Neck Cancer Patients

描述(由申请人提供)：头颈部鳞状细胞癌(HNSCC)的治疗通常会导致相当大的功能障碍。因此，HNSCC患者的生活质量显著下降，情绪困扰程度高，人际关系恶化，社会孤立程度增加。研究表明，心理教育干预可以改善不同癌症人群的生活质量，减少痛苦，并加强对癌症的应对。然而，针对HNSCC患者制定的干预计划很少。因此，为HNSCC患者开发适当的心理教育干预措施将满足这一患者群体的重大需求。然而，由于癌症和癌症治疗对面部外观和说话能力的影响，面对面提供的心理教育干预可能对一些HNSCC患者不太有吸引力，他们可能因为社交焦虑或感到耻辱而不愿参与社交活动。小组环境和面对面的互动可能会导致HNSCC患者高度的社交焦虑，特别是那些说话有问题的患者。因此，以网络为基础的多媒体干预可能是以有效、实用和可接受的形式向这一人群提供关键信息的一个有吸引力的选择。因此，拟议的第一阶段项目的目标是为HNSCC患者开发一个基于网络的多媒体干预原型。该项目的具体目标是：1)开发一个基于网络的原型多媒体程序，其中包含四个主题领域的信息，包括：头颈癌及其治疗；吞咽和口腔护理的潜在变化；语言的潜在变化；以及应对癌症；以及2)评估45名HNSCC患者和5名医疗保健专业人员对基于网络的原型程序的接受度和满意度。如果成功，将在第二阶段创建一个修订和完整的原型，然后将评估这种基于网络的干预在提高生活质量方面的有效性。拟议的项目解决了研究不足的癌症患者群体的重大需求，这些患者在心理、社会和身体功能方面遭受了相当大的损害。拟议的第一阶段项目的结果将被用作第二阶段应用的初步数据，以进行随机对照试验，以评估基于网络的干预在改善HNSCC患者的生活质量和心理适应方面的效果。 公共卫生相关性：尽管有证据表明心理教育干预可以改善不同癌症人群的生活质量，减少心理痛苦，并加强对癌症的应对，但很少有研究开发和评估针对头颈癌患者的此类干预措施。为HNSCC患者开发基于网络的心理教育干预具有几个优点，包括：1)可在家中管理的多媒体演示格式，从而使其实施更可行，更容易为患者接受；以及2)此类干预的传播潜力相对较高。拟议项目的一个长期目标是评估这种基于网络的干预在提高头颈癌患者的生活质量和心理调整方面的有效性。

DESCRIPTION (provided by applicant): Treatment for head and neck squamous cell carcinoma (HNSCC) often confers considerable functional impairment. As a result, HNSCC patients experience significant decrements in quality of life, high levels of emotional distress, deteriorations in interpersonal relations, and increased social isolation. Studies suggest that psychoeducational interventions can improve quality of life, reduce distress, and enhance coping with cancer in various cancer populations. However, few intervention programs have been developed for HNSCC patients. As such, the development of appropriate psychoeducational interventions for HNSCC patients would address a significant need in this patient population. However, due to the effects of cancer and cancer treatment on facial appearance and speaking ability, psychoeducational interventions that are delivered in-person may be less appealing to some HNSCC patients who may be reluctant or unwilling to engage in social interactions due to social anxiety or feeling stigmatized. Group settings and face-to-face interactions can contribute to high levels of social anxiety among HNSCC patients, particularly those who experience problems with speaking. Hence, web-based multimedia interventions may represent an appealing option for delivering key information to this population in an efficacious, practical and acceptable format. Therefore, the goal of the proposed Phase I project is to develop a prototype web-based multimedia intervention for HNSCC patients. The specific aims of the project are to: 1) Develop a prototype web-based multimedia program that incorporates information in four topic areas, including: Head and Neck Cancer and its Treatment; Potential Changes in Swallowing and Oral Care; Potential Changes in Speech; and Coping with Cancer; and 2) Evaluate acceptability and satisfaction with the prototype web-based program among 45 HNSCC patients and 5 healthcare professionals. If successful, a revised and complete prototype will be created in Phase II, and the effectiveness of this web-based intervention in enhancing quality of life will then be evaluated. The proposed project addresses a significant need in an understudied cancer patient population that suffers considerable impairment in psychosocial and physical functioning. Findings from the proposed Phase I project will be used as preliminary data for a Phase II application to conduct a randomized controlled trial to evaluate the efficacy of the web-based intervention in improving quality of life and psychological adjustment among HNSCC patients. PUBLIC HEALTH RELEVANCE: Although there is evidence that psychoeducational interventions can improve quality of life, reduce psychological distress, and enhance coping with cancer in various cancer populations, few studies have developed and evaluated such interventions for head and neck cancer patients. The development of a web-based psychoeducational intervention for HNSCC patients has several strengths, including: 1) a multimedia presentation format that can be administered at home, thereby making it more feasible to implement and more acceptable to patients; and 2) the relatively high dissemination potential of such an intervention. A long-term goal of the proposed project is to evaluate the effectiveness of this web-based intervention in enhancing quality of life and psychological adjustment among head and neck cancer patients.