Enhancing Survivorship Care Planning for Patients with Localized Prostate Cancer Using A Couple-focused Web-based Tailored Symptom Self-management Program

使用以夫妇为中心、基于网络的定制症状自我管理计划，加强局限性前列腺癌患者的生存护理计划

• 批准号: 9225993
• 负责人: Lixin Song
• 金额: $ 19.84万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-12-01 至 2018-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9225993
• 关键词: Address; Adverse effects; Advertising; Aftercare; Age; American Cancer Society; Area; Behavior; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caring; Cellular Phone; Characteristics; Computers; Control Groups; Couples; Data; Diet; E-learning; Effectiveness; Emotional; Enrollment; Family; Fatigue; Feasibility Studies; Generic Drugs; Guidelines; Health; Health Services; Health behavior; Hormonal; Human Resources; Incidence; Institute of Medicine (U.S.); Internet; Intervention; Intestines; Knowledge; Learning Module; Link; Malignant Neoplasms; Malignant neoplasm of prostate; Methods; Mission; Modeling; Nature; Newly Diagnosed; Online Systems; Organism; Outcome; Pain; Participant; Patient Care Planning; Patient-Focused Outcomes; Patients; Physical activity; Provider; Quality of life; Randomized; Randomized Clinical Trials; Recruitment Activity; Reporting; Resources; Self Efficacy; Self Management; Services; Sleep disturbances; Slide; Social support; Standardization; Suggestion; Support Groups; Supportive care; Survivors; Symptoms; Tablets; Technology; Testing; Text; Time; United States National Institutes of Health; Visit; active method; base; cancer care; cancer education; cost; design; efficacy testing; emotional distress; evidence base; group intervention; improved; innovation; mHealth; men; neoplasm resource; peer support; preference; primary outcome; programs; randomized trial; response; retention rate; routine care; satisfaction; secondary outcome; skills training; social; survivorship; symptom management; symptom self management; symptomatic improvement; theories; tool; uptake; urinary

PROJECT SUMMARY Supporting NIH's mission, this project aims to explore a new model of care that enhances survivorship care planning and promotes health for patients with localized prostate cancer (PCa) transitioning to post-treatment self-management. Survivorship care planning for patients with PCa is important because of the high incidence rates of PCa in the U.S., the frequent occurrence of treatment-related side effects, and reduced quality of life (QOL) in both patients and their partners (for patients who are partnered). Emerging evidence suggests that use of regular survivorship care plans (SCPs) does not improve health service and patient outcomes because the content in mandated SCPs does not consider patients' information and care needs. We plan to integrate an evidence-based, theory-driven symptom self-management program, Prostate Cancer Education & Resources for Couples (PERC), with standardized SCPs and build enhanced SCPs (ESCPs). ESCPs will engage both patients and partners during survivorship care planning and provide a one-stop, comprehensive PERC program to improve their QOL and decrease patient use of post-treatment care services. The couple-focused, web-based tailored PERC program includes 12 online modules with assignments, a moderated chat room and a resource center. Tailored to patients' and partners' characteristics and preferences to address their specific care needs, PERC helps couples reduce negative appraisals of symptoms, increase access to social support, and enhance self-efficacy and health behaviors for symptom self-management. In this study, we propose to test the feasibility of ESCPs (regular SCPs with the PERC web link) and to conduct an initial benefit assessment of ESCPs. We will use a two-group (ESCP=intervention and SCP only=negative control) randomized controlled pretest-posttest design and collect data at baseline (T1) and 4 months later (T2) among 50 patients completing initial treatment for localized PCa and their partners. The specific aims are: Aim 1: Examine the feasibility of delivering ESCPs (as assessed by recruitment, enrollment, and retention rates, satisfaction with ESCP, and perceived ease of use of PERC). We will use mixed methods to achieve this aim. Aim 2: Estimate the magnitude of benefit of ESCPs. We hypothesize that, compared with the SCP only users, the ESCP users will report (1) greater improvement in their primary outcomes of QOL (overall, physical, emotional, and social QOL); (2) greater improvement in secondary outcomes (reduction in negative appraisals and improvement in self-efficacy, social support, and health behaviors to manage symptoms); and (3) fewer visits to post-treatment care services from between T1 and T2. The results from this study will help design a definitive randomized trial to test the efficacy of ESCP. The innovative ESCPs will strengthen survivorship care planning and allow PERC to be disseminated broadly and systematically without the need for costly resources or personnel. This proposed project is in response to calls for programs from the Institute of Medicine and American Cancer Society to address treatment-related effects and help cancer survivors maintain their QOL.

项目总结 为了支持美国国立卫生研究院的使命，该项目旨在探索一种新的护理模式，以加强生存护理 为过渡到治疗后的局限性前列腺癌(PCA)患者规划和促进健康 自我管理。由于前列腺癌发病率较高，制定生存护理计划非常重要。 美国前列腺癌的发生率、治疗相关副作用的频繁发生以及生活质量的降低 (QOL)在患者和他们的伴侣中(对于有伴侣的患者)。新出现的证据表明 使用常规的生存护理计划(SCP)并不能改善医疗服务和患者结局，因为 强制SCP中的内容没有考虑患者的信息和护理需求。我们计划整合一个 循证、理论驱动的症状自我管理计划，前列腺癌教育与资源 为夫妻(PERC)提供标准化的SCP，并建立增强型SCP(ESCP)。ESCP将让双方都参与进来 患者和合作伙伴在生存护理计划期间，并提供一站式、全面的PERC 计划，以提高他们的生活质量，减少患者对治疗后护理服务的使用。这对夫妇专注于 基于网络的定制PERC课程包括12个带有作业的在线模块、一个主持人聊天室和 一个资源中心。根据患者和伴侣的特点和偏好量身定做，以满足他们的特定需求 护理需求，PERC帮助夫妇减少对症状的负面评估，增加获得社会支持的机会， 增强症状自我管理的自我效能感和健康行为。在这项研究中，我们建议 测试ESCP(具有PERC网络链接的常规SCP)的可行性，并进行初步收益 对ESCP的评估。我们将使用两组(ESCP=干预，仅SCP=阴性对照) 随机对照前测-后测设计并在基线(T1)和4个月后(T2)收集数据 50名完成初步治疗的局限性前列腺癌患者及其伴侣。具体目标是：目标1： 审查提供ESCP的可行性(通过招聘、注册和留存率进行评估， 对ESCP的满意度，以及对PERC易用性的感知)。我们将使用混合方法来实现这一目标。 目标2：估计ESCP的惠益程度。我们假设，与仅使用SCP的用户相比， ESCP用户将报告：(1)他们的主要生活质量结果(总体、身体、 情感、社交生活质量)；(2)二次结果的更大改善(减少负面评价 在自我效能感、社会支持和管理症状的健康行为方面的改善)；和(3)较少 在T1和T2之间访问治疗后护理服务。这项研究的结果将有助于设计一种 用于测试ESCP疗效的确定性随机试验。创新的ESCP计划将加强生存护理 规划并允许广泛和系统地传播PERC，而不需要昂贵的资源 或者是人员。这项拟议的项目是为了响应医学和医学研究所的项目呼吁 美国癌症协会致力于解决与治疗相关的影响，并帮助癌症幸存者维持其生活质量。