Efficacy of a Couple-focused, Tailored, Symptom Self-Management mHealth Intervention for Prostate Cancer Patients and Partners

以夫妻为中心、量身定制的症状自我管理移动健康干预措施对前列腺癌患者和伴侣的功效

• 批准号: 10200890
• 负责人: Lixin Song
• 金额: $ 47.12万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-25 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10200890
• 关键词: Address; Adherence; Adverse effects; Affect; Aftercare; Age; American Cancer Society; Attitude; Behavior; Cancer Advocacy; Cancer Center; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caregivers; Caring; Cellular Phone; Chronic; Chronic Disease; Communication; Communities; Computers; Control Groups; Couples; Diagnosis; Distress; Education; Effectiveness; Electronic Mail; Ethnic Origin; Family; Fatigue; Geography; Goals; Guidelines; Health Technology; Health behavior; Home; Hormonal; Impairment; Individual; Institute of Medicine (U.S.); Internet; Intervention; Intestines; Knowledge; Learning Module; Localized Disease; Malignant Neoplasms; Malignant neoplasm of prostate; Methodology; Methods; Modeling; National Cancer Institute; National Institute of Nursing Research; Newly Diagnosed; Oncology; Online Systems; Operative Surgical Procedures; Pain; Participant; Patient Care; Patients; Persons; Physicians' Offices; Pilot Projects; Prostate Cancer therapy; Quality of life; Race; Radiation; Randomized Clinical Trials; Randomized Controlled Trials; Regional Disease; Reporting; Research; Resources; Self Care; Self Efficacy; Self Management; Sleep disturbances; Social support; Source; Stress and Coping; Support Groups; Supportive care; Survivors; Symptoms; Tablets; Telephone; Testing; Text; Time; Travel; Treatment-Related Cancer; Uncertainty; acronyms; active method; base; cancer therapy; cancer type; care providers; cohort; coping; design; education resources; efficacy testing; emotional distress; evidence base; experience; hormone therapy; improved; innovation; intimate behavior; mHealth; men; novel; patient-clinician communication; peer support; population based; preference; primary caregiver; programs; response; satisfaction; secondary outcome; side effect; skills; skills training; survivorship; symptom management; symptom self management; symptom treatment; symptomatic improvement; theories; tool; treatment as usual; treatment effect; urinary; usability; user-friendly; web portal; web site

PROJECT SUMMARY/ABSTRACT Over 180,000 men will be diagnosed with localized prostate cancer in 2016 and 92% of these men will have localized or regional disease. Fortunately, treatment with curative intent (surgery or radiation with/without hormone therapy) provides long-term cancer-free survival. However, survivors experience urinary, sexual, bowel and hormonal symptoms, general distress, pain, fatigue, and sleep disturbance. For men in an intimate relationship, these symptoms disrupt couple’s relationships and intimacy, and reduce quality of life (QOL) of both patients and their partners who are often their primary caregivers. Symptom effects may have as great or greater impact on their partners’ QOL than on patients’ own QOL. Management of the negative effects of cancer and its treatment is a significantly under-addressed supportive care need for these men and their intimate partners. Most existing online programs are not couple-focused or use generalized “one-size fits all” approaches that have fallen short of improving QOL. Existing in-person couple-focused programs are expensive and inconvenient because of the time and travel required. To address these unmet supportive care needs, Dr. Song led an interdisciplinary team to develop and pilot test the usability and feasibility of an evidence-based, couple-focused, tailored mobile health (mHealth) intervention, “Prostate Cancer Education & Resources for Couples” (PERC). Based on the adapted stress-coping theoretical framework and developed with stakeholder involvement, PERC aims to improve QOL for both patients and partners through enhancing positive appraisals, self-efficacy, social support, and healthy behaviors for symptom management. Using mHealth technologies, PERC provides comprehensive, user-friendly content, and uses tailoring and personalization features designed to increase personal relevance of, and couples’ accessibility to PERC modules. We propose to rigorously test the efficacy of PERC using a population-based, geographically and demographically diverse cohort in a randomized controlled trial. The specific aims are: Primary Aim: Assess if patients and partners receiving PERC will report greater improvement in their cancer-related QOL scores than those in the control group (usual care plus the National Cancer Institute (NCI) prostate cancer website) at 4, 8, and 12 months post-baseline. Secondary Aim: Test if patients and partners in PERC will report significantly more positive appraisals and higher levels of coping resources at follow-ups than those in the control group. Exploratory Aim: Determine if patient race and ethnicity, education, type of treatment, or couples’ relationship quality moderate the effects of PERC on patient and partner QOL at follow-ups. This study will provide a novel model for self-managing chronic illness symptoms that impact couples’ relationships, intimacy, and QOL. It addresses the National Institute of Nursing Research’s (NINR) goal to develop and test new strategies for symptom self-management to help patients and caregivers better manage their illness and improve QOL. It also responds to calls for programs from the Institute of Medicine (IOM) and American Cancer Society (ACS) to address treatment-related effects and improve survivors’ QOL.

项目总结/摘要 2016年将有超过180，000名男性被诊断患有局限性前列腺癌，其中92%的男性将患有局限性或 区域性疾病。幸运的是，以治愈为目的的治疗（手术或放射治疗，有/没有激素治疗）提供了 长期无癌生存。然而，幸存者经历泌尿，性，肠道和激素症状，一般 痛苦、疼痛、疲劳和睡眠障碍。对于处于亲密关系中的男性来说，这些症状会破坏夫妻关系。 关系和亲密关系，并降低患者及其伴侣的生活质量（QOL），这些患者及其伴侣通常是他们的主要 照顾者症状效应对伴侣生活质量的影响可能与对患者自身生活质量的影响一样大或更大。 癌症及其治疗的负面影响的管理是一个明显未得到解决的支持性护理需求， 这些人和他们的亲密伴侣大多数现有的在线课程都不是以夫妇为中心的，或者使用广义的“单一尺寸” “一刀切”的方法，未能改善生活质量。现有的面对面的夫妇为重点的计划是昂贵的 并且由于所需的时间和旅行而不方便。为了解决这些未满足的支持性护理需求，宋博士领导了一个 跨学科团队开发和试点测试的可用性和可行性，以证据为基础，夫妇为重点，量身定制 移动的健康（mHealth）干预，“夫妇前列腺癌教育和资源”（PERC）。基于 适应压力应对的理论框架，并与利益相关者的参与发展，PERC旨在提高生活质量 通过提高积极评价、自我效能、社会支持和健康行为， 用于症状管理。使用mHealth技术，PERC提供全面、用户友好的内容，并使用 定制和个性化功能，旨在提高个人相关性和夫妻对PERC的可访问性 模块。我们建议使用基于人口的、地理上的和 随机对照试验中的人口统计学多样性队列。具体目的是：主要目的：评估患者是否 接受PERC治疗的患者和合作伙伴将报告其癌症相关QOL评分比对照组有更大的改善 组（常规治疗加国家癌症研究所（NCI）前列腺癌网站）在基线后4、8和12个月。 次要目的：测试PERC中的患者和伴侣是否会报告更多积极评价和更高水平 随访时应对资源的利用率高于对照组。探索性目的：确定患者种族和 种族、教育、治疗类型或夫妻关系质量会调节PERC对患者的影响， 随访时的伴侣QOL。这项研究将为自我管理慢性疾病症状提供一种新的模式， 夫妻关系亲密度和生活质量它解决了国家护理研究所（NINR）的目标， 开发和测试症状自我管理的新策略，以帮助患者和护理人员更好地管理他们的疾病 提高QOL。它还响应了医学研究所（IOM）和美国癌症研究所的项目呼吁 美国癌症学会（ACS）的研究，以解决治疗相关的影响，提高幸存者的生活质量。

项目成果

Testing the efficacy of a couple-focused, tailored eHealth intervention for symptom self-management among men with prostate cancer and their partners: the study protocol.

• DOI: 10.1186/s13063-021-05948-5
• 发表时间: 2022-01-04
• 期刊: Trials
• 影响因子: 2.5
• 作者: Song L;Nielsen ME;Chen RC;Rini C;Keyserling TC;Idiagbonya E;Fuller GP;Northouse L;Palmer MH;Tan X
• 通讯作者: Tan X

Systematic review of illness uncertainty management interventions for cancer patients and their family caregivers.

对癌症患者及其家庭护理人员的疾病不确定性管理干预措施的系统评价。

• DOI: 10.1007/s00520-020-05931-x
• 发表时间: 2021-08
• 期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
• 作者: Guan T;Qan'ir Y;Song L
• 通讯作者: Song L

Factors related to tracheostomy timing and ventilator weaning: findings from a population in Northern Taiwan.

与气管切开时机和呼吸机脱机相关的因素：来自台湾北部人群的调查结果。

• DOI: 10.1111/crj.12492
• 发表时间: 2018
• 期刊: The clinical respiratory journal
• 作者: Chen,Hui-Chin;Song,Lixin;Chang,Hsin-Chieh;Hsu,Min-Tao
• 通讯作者: Hsu,Min-Tao

Intelligent Conversational Agents in Patient Self-Management: A Systematic Survey Using Multi Data Sources.

患者自我管理中的智能会话代理：使用多数据源的系统调查。

• DOI: 10.3233/shti190661
• 发表时间: 2019
• 期刊: Studies in health technology and informatics
• 作者: Xing,Zhaopeng;Yu,Fei;Qanir,YousefAMustafa;Guan,Ting;Walker,Jennifer;Song,Lixin
• 通讯作者: Song,Lixin

Research Agenda of the Oncology Nursing Society: 2019-2022.

肿瘤护理学会研究议程：2019-2022。

• DOI: 10.1188/19.onf.654-669
• 发表时间: 2019
• 期刊: Oncology nursing forum
• 影响因子: 1.9
• 作者: VonAh,Diane;Brown,CarltonG;Brown,SusanJ;Bryant,AshleyL;Davies,Marianne;Dodd,Marylin;Ferrell,Betty;Hammer,Marilyn;Knobf,MTish;Knoop,TeresaJ;LoBiondo-Wood,Geri;Mayer,DeborahK;Miaskowski,Christine;Mitchell,SandraA;Song,Li
• 通讯作者: Song,Li