"Beyond Cancer":Fostering transitions post-treatment

描述（由申请人提供）：在过去的20年中，所有癌症部位的相对5年生存率都有所增加。越来越多的患者正在完成治疗并进入治疗后的早期阶段，以应对他们的疾病。治疗阶段结束时，患者的情绪和身体可能会受到损害。这些问题通常没有得到卫生保健提供者的承认和解决，因此，有些长期幸存者永远无法恢复“正常”生活。大多数现有的干预措施使用面对面的形式，因此限制了它们的使用，只有那些有能力“到达”干预地点的个人。拟议的两阶段试点研究旨在修改并评估修改后的干预战略的可接受性和可行性，该战略旨在促进恢复生产性生活和改善生活质量。拟议的研究解决了先前发现的差距和局限性：研究男性和女性癌症患者，使用两种性别中立的肿瘤；结合病人和照顾者的观点；通过阻断性别来控制潜在的性别差异；在治疗后的前3个月内进行干预；并采用一种使干预措施广泛可及的形式[录像带、手册、电话会议]。特别地，本建议解决以下问题：(1)在结直肠癌、霍奇金病或非霍奇金淋巴瘤患者及其主要照顾者完成治疗后的前3个月，如何调整现有的认知行为干预计划？(2)在完成治疗后的前3个月，患者和护理人员对改进后的认知行为干预方案的接受程度如何？(3)干预对参与者报告的感知控制、应对、感知社会支持和生活质量有何影响？影响有多大？在第一阶段，我们将进行描述性研究，以获得对现有干预措施的反馈。参与者将获得现有的干预录像带和练习册以及评估问题。在审查材料后，将进行焦点小组讨论，以获得具体的反馈。对于第二阶段，将进行随机临床试验，以评估改进干预措施的可接受性/可行性，并确定对生活质量和其他相关结果的影响。

DESCRIPTION (provided by applicant): The relative 5-year survival rate for all cancer sites has increased over the past 20 years. More patients are completing treatment and entering the early post-treatment phase of coping with their illness. The end of treatment phase may be emotionally and physically crippling. These issues are typically not recognized and addressed by health care providers, and therefore, there are long-term survivors who never resume a 'normal' life. Most existing interventions use a face-to-face format, thus limiting their use to individuals who have the ability to 'get to' the intervention site. The proposed two-stage pilot study seeks to modify and then evaluate the acceptability and feasibility of the modified intervention strategy designed to enhance the return to a productive existence and improve quality of life. The proposed study addresses the previously identified gaps and limitations by: studying men and women cancer patients using two tumors that are gender neutral; incorporating the patient's and caregiver's perspectives; controlling for potential gender differences by blocking on gender; delivering the intervention during the first 3 months post-treatment; and using a format that makes the intervention widely accessible [videotapes, a manual, telephone conference calls]. In particular, this proposal addresses the following questions: (1) How does an existing cognitive behavioral intervention program need to be adapted for use during the first 3 months following treatment with patients completing treatment for colorectal cancer, Hodgkin's disease, or Non-Hodgkin's lymphoma and their primary caregivers?; (2) How acceptable is the modified cognitive behavioral intervention program to patients and caregivers during the first 3 months after completing treatment?; and (3) What effects does the intervention have on the perceived control, coping, perceived social support, and quality of life reported by the participants? How sizable are the effects? In the first stage, we will conduct a descriptive study to elicit feedback about the existing intervention. Participants will be given the existing intervention videotapes and workbook along with evaluation questions. After reviewing the materials, a focus group to elicit specific feedback will be conducted. For Stage Two, a randomized clinical trial will be conducted to evaluate the acceptability/feasibility of the modified intervention as well as to determine the effects on quality of life and other related outcomes.