Recovery Support for Bladder CA Patients and Caregivers: A Multimodal Approach
膀胱 CA 患者和护理人员的康复支持:多模式方法
基本信息
- 批准号:10672260
- 负责人:
- 金额:$ 49.72万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2018
- 资助国家:美国
- 起止时间:2018-07-01 至 2024-12-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAftercareAgeAreaAttentionBladderBody ImageCancer InterventionCancer PatientCaregiversCaringCategoriesClimactericClinicalCombined Modality TherapyComplexCost AnalysisDataData AnalysesDevelopmentDiagnosisDiseaseDistressEducationEmergency CareEmergency department visitEvaluationExcisionFaceFeelingFemaleFrightFutureGenderGoalsHealth ProfessionalHealth PromotionHome visitationHospitalsIleal conduit procedureInfectionInformation ResourcesInstructionInterventionKnowledgeLearningLiteratureMaintenanceMalignant neoplasm of urinary bladderMediatingMediatorMedicalModelingOnline SystemsOperative Surgical ProceduresParticipantPatient CarePatientsPersonsPhasePhysiciansPilot ProjectsPreparationProstatePublishingQuality of lifeRandomizedRandomized, Controlled TrialsRecoveryRecovery SupportRecurrenceRegimenResearchResearch MethodologySamplingSavingsSelf CareSelf EfficacySpousesStomasSystemTechnologyTestingTimeTreatment EfficacyVisitVisiting NurseWorkcaregivingclinical applicationclinical carecomparison groupcopingcostcost effectiveexperiencegroup interventionhealth traininghuman old age (65+)implementation costimprovedinnovationintervention costintervention effectlymph nodesmultimodalitymuscle invasive bladder cancernovelprimary outcomeprogramspsychologicpsychosocialreadmission ratessecondary outcomeskillssocialstandard of caresurvivorshiptherapy designusabilityweb-based intervention
项目摘要
ABSTRACT
Treatment for muscle invasive bladder cancer (MIBC) involves the removal of the bladder and construction of a
new voiding system and is physically and psychologically profoundly challenging for patients and caregivers.
Based on our published literature and extensive pilot data, patients and caregivers have extensive unmet
informational, social, psychological, instrumental, and medical needs from the time of diagnosis, through
treatment and recovery which are not adequately addressed by health care professionals. We propose to
address these unmet needs through the refinement and evaluation of a comprehensive, 2-part (in-person and
web-based) intervention, geared towards the patient and caregiver. Specifically, during Aim 1, the formative
phase, we propose to further refine our newly developed intervention components with the help of an
established patient/caregiver advisory board. The intervention, Recovery Support for Bladder Cancer (RSBC),
consists of a pre-treatment, in-person preparatory instructional session with a trained health care professional
(Module 1) to equip patients and caregivers with the skills to adjust to the upcoming treatment and recovery
period. This is followed by a post-treatment, interactive web-based program (Module 2) to provide further
support for both patients and caregivers to enhance quality of life (QOL) and reduce infections and nurse/ER
visits. The RSBC intervention will be evaluated in a 12-month randomized controlled trial (Aim 2) among
patients and caregiver dyads (N=330 initial; 230 final sample) against a time and attention comparison
condition that incorporates standard of care discharge instructions and modules focusing on wellness. Primary
outcomes for both patients and caregivers will be improved QOL, which is hypothesized to be significantly
higher among participants randomized into RSBC. Secondary outcomes will be fewer infections and nurse-
ER visits for patients randomized into RSBC. Aim 3 proposes moderator (i.e., age, gender, surgical diversion
type) and mediator (i.e., patient activation, distress) analyses of intervention efficacy. We hypothesize that
RSBC will be significantly more successful among (a) older, (b) female participants, and (c) patients with a
conduit diversion type. Elevated levels of patient activation (i.e., higher self-care knowledge, self-efficacy, lower
distress) will mediate the intervention effects. Exploratory Aim 4 will examine the costs and potential savings
associated with developing and implementing the RSBC intervention. We hypothesize that initial development
and implementation costs of RSBC will be offset by reduced nurse/ER visits. The scientific premise is strong
and supported by an established theoretical framework, extensive pilot data and a rigorous application of
clinical research methods. The proposed study is highly innovative, as it comprehensively addresses unmet
needs of both patients and caregivers from pre- and (immediate) post-treatment to recovery. This is achieved
through an innovative combination of in-person preparation and skill-building and web-based technology. If
successful, RSBC has the potential to significantly change clinical care for patients and caregivers with MIBC.
摘要
肌层浸润性膀胱癌(MIBC)的治疗包括切除膀胱并构建一个
新的排泄系统,对患者和护理人员的身体和心理都具有深刻的挑战性。
根据我们已发表的文献和广泛的试点数据,患者和护理人员有广泛的未满足
信息,社会,心理,工具和医疗需求,从诊断的时间,通过
医疗保健专业人员没有充分处理的治疗和康复问题。我们建议
通过完善和评估由两部分组成的综合性(面对面和
基于网络的)干预,面向患者和护理者。具体而言,在目标1中,
我们建议在第三阶段,借助
建立病人/护理人员咨询委员会。膀胱癌康复支持(RSBC)
由经过培训的医疗保健专业人员进行的治疗前现场准备指导会议组成
(模块1)使患者和护理人员具备适应即将到来的治疗和康复的技能
期随后是一个治疗后,互动式基于网络的程序(模块2),以提供进一步的
为患者和护理人员提供支持,以提高生活质量(QOL)并减少感染和护理/ER
探访RSBC干预将在一项为期12个月的随机对照试验(目标2)中进行评估,
患者和护理人员二人组(N=330初始样本; 230最终样本)与时间和注意力比较
条件,包括护理标准出院指示和侧重于健康的模块。初级
患者和护理人员的结局将改善QOL,假设QOL显著
在随机分配到RSBC的参与者中,次要结果将是减少感染和护理-
随机分配至RSBC的患者的ER访视。目标3提议主持人(即,年龄、性别、手术分流
类型)和中介体(即,患者激活、痛苦)的干预效果分析。我们假设
RSBC在(a)老年受试者,(B)女性受试者,和(c)
管道导流型患者激活水平升高(即,自我保健知识、自我效能感较高,
(2)干预效果的中介作用。探索性目标4将研究成本和潜在的节约
与制定和实施RSBC干预措施有关。我们假设最初的发展
RSBC的实施费用将通过减少护士/急诊室访问来抵消。科学前提是强有力的
并得到了既定的理论框架、广泛的试点数据和严格应用的支持,
临床研究方法。拟议的研究具有高度创新性,因为它全面解决了未得到满足的问题,
患者和护理人员从治疗前和(立即)治疗后到康复的需求。实现这一点
通过创新性地将亲自准备、技能培养和基于网络的技术相结合。如果
RSBC的成功,有可能显着改变与MIBC患者和护理人员的临床护理。
项目成果
期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Management of Distress in Patients with Cancer-Are We Doing the Right Thing?
- DOI:10.1093/abm/kaaa091
- 发表时间:2020-12-01
- 期刊:
- 影响因子:0
- 作者:Dekker J;Graves KD;Badger TA;Diefenbach MA
- 通讯作者:Diefenbach MA
Patterns of alcohol use among early head and neck cancer survivors: A cross-sectional survey study using the alcohol use disorders identification test (AUDIT).
- DOI:10.1016/j.oraloncology.2021.105328
- 发表时间:2021-08
- 期刊:
- 影响因子:4.8
- 作者:Teckie, Sewit;Wotman, Michael;Marziliano, Allison;Orner, David;Yi, Jungen;Mulvany, Colm;Ghaly, Maged;Parashar, Bhupesh;Diefenbach, Michael A.
- 通讯作者:Diefenbach, Michael A.
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Michael A Diefenbach其他文献
USING GROWTH CURVE MODELING TO EXAMINE QUALITY OF LIFE AMONG PROSTATE CANCER SURVIVORS: RESULTS FROM A 36 MONTHS LONGITUDINAL STUDY
- DOI:
10.1016/s0022-5347(08)61156-8 - 发表时间:
2008-04-01 - 期刊:
- 影响因子:
- 作者:
Michael A Diefenbach;William Dudley - 通讯作者:
William Dudley
Michael A Diefenbach的其他文献
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{{ truncateString('Michael A Diefenbach', 18)}}的其他基金
Reducing Burden in Care Partners of Community-Dwelling Persons with Dementia and Oropharyngeal Dysphagia
减轻社区居民痴呆症和口咽吞咽困难患者护理伙伴的负担
- 批准号:
10570435 - 财政年份:2023
- 资助金额:
$ 49.72万 - 项目类别:
Recovery Support for Bladder CA Patients and Caregivers: A Multimodal Approach
膀胱 CA 患者和护理人员的康复支持:多模式方法
- 批准号:
10216197 - 财政年份:2018
- 资助金额:
$ 49.72万 - 项目类别:
Recovery Support for Bladder CA Patients and Caregivers: A Multimodal Approach
膀胱 CA 患者和护理人员的康复支持:多模式方法
- 批准号:
10436957 - 财政年份:2018
- 资助金额:
$ 49.72万 - 项目类别:
Novel Approach to Facilitate Decisions in Patients w/ Muscle Invasive Bladder CA
促进肌肉侵袭性膀胱 CA 患者决策的新方法
- 批准号:
8876159 - 财政年份:2015
- 资助金额:
$ 49.72万 - 项目类别:
Novel Approach to Facilitate Decisions in Patients w/ Muscle Invasive Bladder CA
促进肌肉侵袭性膀胱 CA 患者决策的新方法
- 批准号:
9057990 - 财政年份:2015
- 资助金额:
$ 49.72万 - 项目类别:
Decision Making For Active Surveillance in Prostate Cancer Patients and Spouses
前列腺癌患者和配偶主动监测的决策
- 批准号:
8534064 - 财政年份:2012
- 资助金额:
$ 49.72万 - 项目类别:
Decision Making For Active Surveillance in Prostate Cancer Patients and Spouses
前列腺癌患者和配偶主动监测的决策
- 批准号:
8386407 - 财政年份:2012
- 资助金额:
$ 49.72万 - 项目类别:
Brief Intervention to Improve QOL & Couple Functioning after Prostate Surgery
改善生活质量的简短干预
- 批准号:
8301574 - 财政年份:2011
- 资助金额:
$ 49.72万 - 项目类别:
Brief Intervention to Improve QOL & Couple Functioning after Prostate Surgery
改善生活质量的简短干预
- 批准号:
8190005 - 财政年份:2011
- 资助金额:
$ 49.72万 - 项目类别:
Trajectories of QOL in Prostate Cancer Survivors using Growth Curve Modeling
使用生长曲线模型研究前列腺癌幸存者的生活质量轨迹
- 批准号:
7476125 - 财政年份:2008
- 资助金额:
$ 49.72万 - 项目类别:
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