HRQOL-enhancing ostomy self-management intervention for CRC survivors

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DESCRIPTION (provided by applicant): Our aims are consonant with the NCI's strategic objective to improve the quality of life for cancer patients, survivors, and their families, as well as with the Institute of Medicine's Chronic Care Model, which seeks to transform what is currently a reactive health care system into one that keeps patients as healthy as possible through planning, proven strategies and management. Colorectal cancer (CRC) and other cancer patients who are required to undergo intestinal ostomies, face many obstacles in coping with their condition, not least of which is medical care that often does not meet their needs for effective training and information regarding self-care, clinical management, or psychological support. Ostomates and their families must engage in ostomy management, make behavioral changes, and adjust to the consequences of this condition. This may include a family member or friend becoming the principal caretaker. Preparation of the patient and their chosen caregiver is requisite to assure optimal HRQOL and functioning. Our primary aim is to recruit a group of community cancer patients through three community hospitals to test the feasibility, acceptability, and comprehensibility of a Chronic Care Ostomy Self-Management (CCOSM) Program facilitated by a certified ostomy care nurse (COCN) and trained peer-ostomate "buddies". Secondary aims are to: a) evaluate the patient- and caregiver-rated effectiveness of each session; b) obtain interventionists' estimates of the effectiveness of each session for each participant at the end of the sessions; c) use exit interviews to evaluate the acceptability of, and satisfaction with, the program; d) evaluate relationships and correlations between ostomy-specific HRQOL scores and both Activation (PAM) scale scores and Ways of Coping (WAYS) patterns and scores; e) measure CCOSM program costs and patient/family out of pocket expenses to participate in the program; and f) develop the infrastructure and strategy for a larger intervention study. Our long term objectives are to initiate a randomized, controlled, multi-site Chronic Care Ostomy Self-Management Program intervention study for CRC and other cancer survivors. The ultimate goal of this research is to develop an effective, satisfying and exportable system of care for CRC and other cancer patients with new intestinal stomas so that they can maintain their maximum HRQOL and functioning, using an evidence-based, clinically and cost-effective, sustainable ostomy-management program, incorporating "buddy" peers, along with patient and family education and support. Importantly, we will create the infrastructure for a larger intervention study. PUBLIC HEALTH RELEVANCE: The ultimate goal of this research is to develop an effective, satisfying and easily usable system of care for colorectal and other cancer patients with new fecal intestinal stomas so that they can maintain their maximum health-related quality of life and functioning, using an evidence-based, clinically and cost-effective, sustainable ostomy-management program, incorporating "buddy" peers, along with patient and family education and support. Our aims follow the National Cancer Institute's strategic objective to improve the quality of life for cancer patients, survivors, and their families, as well as with the Institute of Medicine's Chronic Care Model, which seeks to transform what is currently a reactive health care system into one that keeps patients as healthy as possible through planning, proven strategies and management.