Survivorship Care Planning and Communication for Rural Breast Cancer Survivors

农村乳腺癌幸存者的生存护理规划和沟通

• 批准号: 8191564
• 负责人: Ann M. Geiger
• 金额: $ 16.1万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-22 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8191564
• 关键词: Address; Area; Behavioral Research; Cancer Control; Cancer Survivor; Cancer Survivorship; Caring; Clinical; Communication; Communities; Confusion; Data; Dimensions; Disease; Future; Goals; Grant; Health; Health Services Accessibility; Individual; Institute of Medicine (U.S.); Institution; Intervention; Intervention Studies; Knowledge; Late Effects; Left; Life; Mails; Maintenance; Malignant Neoplasms; Medical; Modeling; Monitor; NIH Program Announcements; Nurse Practitioners; Nurses; Outcome; Patient Preferences; Physician Assistants; Physicians; Preparation; Prevention; Primary Health Care; Process; Provider; Publishing; Quality of life; Recommendation; Reporting; Research; Rural; Specialist; Surveys; Survivors; Symptoms; Telephone Interviews; Testing; Translating; Uncertainty; Work; active method; base; cancer care; design; evidence base; follow-up; information gathering; instrument; malignant breast neoplasm; medical specialties; meetings; oncology; preference; programs; psychosocial; residence; statistics; suburb; survivorship; treatment planning

DESCRIPTION (provided by applicant): The Institute of Medicine and others have strongly recommended survivors exiting active treatment receive a comprehensive survivorship care plan addressing surveillance, late effects symptoms, psychosocial needs, and general health maintenance, as well as indicating which providers will handle which components of the plan. Despite this recommendation, survivorship care planning and communication are often inadequate, leaving survivors confused and uncertain about their care. In addition, little is known about communication- related barriers to survivorship care, which may be of particular concern for rural-residing survivors who often live at some distance from their oncology specialist(s) and have limited primary care access. To reduce confusion and uncertainty, and to avoid duplication of medical effort, we envision a formal planning and communication process that integrates patient preferences with recommendations from multiple providers to generate a comprehensive survivorship care plan. [We believe effective implementation of this process requires a clinically-oriented individual like a nurse, nurse practitioner, physician assistant, or physician to facilitate and coordinate communications between survivors and their primary care and oncology specialty providers.] Our goal is to generate information needed to create and evaluate a process designed specifically to accommodate the needs of rural-residing survivors while also meeting the needs of suburban and urban survivors. Thus we aim to: (1) describe breast cancer survivors' knowledge about, perceived importance of, and barriers to survivorship care planning and communication; (2) assess survivors' current and preferred communication with oncology specialists and primary care providers about their survivorship care plans; and (3) explore the relationship between current survivor and provider survivorship care planning and communication with survivors' cancer-related uncertainty and quality of life. All data will be collected via a survey relying heavily on questions drawn from previously validated instruments and administered via hard copy mail, on-line or telephone interview. Our analytic approach will include descriptive statistics, correlation, and regression modeling. Both this proposal and the resulting testable intervention of a clinical model of survivorship care planning and communication will substantially advance our understanding of cancer survivorship care, particularly for rural-residing breast cancer survivors. PUBLIC HEALTH RELEVANCE: Experts have recommended that the often difficult transition from active treatment to cancer survivorship care be eased by preparation and communication of a survivorship care plan. Our study will gather information about rural-, suburban- and urban-residing cancer survivors' needs and preferences for survivorship care planning and communication. This information will help us design and evaluate a care planning process designed specifically to accommodate the needs of rural-residing survivors while also meeting the needs of suburban- and urban-residing survivors.

描述（由申请人提供）：医学研究所和其他机构强烈建议退出积极治疗的幸存者接受全面的生存护理计划，解决监测，迟发症状，心理社会需求和一般健康维护，以及说明哪些提供者将处理计划的哪些组成部分。尽管有这一建议，但幸存者护理规划和沟通往往不足，使幸存者对自己的护理感到困惑和不确定。此外，对与生存护理相关的沟通障碍知之甚少，这可能是居住在农村的幸存者特别关注的问题，他们通常居住在远离肿瘤专家的地方，并且获得初级护理的机会有限。为了减少混乱和不确定性，并避免重复的医疗工作，我们设想了一个正式的规划和沟通过程，将患者的偏好与多个提供者的建议相结合，以生成一个全面的生存护理计划。[We我认为，有效实施这一过程需要一个以临床为导向的个人，如护士、执业护士、医生助理或医生，以促进和协调幸存者与其初级保健和肿瘤专业提供者之间的沟通。我们的目标是产生所需的信息，以创建和评估一个专门设计的过程，以适应农村居住的幸存者的需求，同时也满足郊区和城市幸存者的需求。因此，我们的目标是：（1）描述乳腺癌幸存者对生存护理计划和沟通的了解、感知的重要性和障碍;（2）评估幸存者与肿瘤学专家和初级保健提供者就其生存护理计划进行的当前和首选沟通;以及（3）探讨当前幸存者和提供者生存护理计划与幸存者癌症沟通之间的关系-不确定性和生活质量。所有数据将通过调查收集，调查主要依赖于从先前验证的工具中提取的问题，并通过硬拷贝邮件、在线或电话访谈进行管理。我们的分析方法将包括描述性统计，相关性和回归建模。这一建议和由此产生的可测试的干预的临床模型的生存护理规划和沟通将大大提高我们的癌症生存护理的理解，特别是对农村居住的乳腺癌幸存者。 公共卫生相关性：专家建议，通过制定和沟通生存护理计划，可以缓解从积极治疗到癌症生存护理的困难过渡。我们的研究将收集有关农村，郊区和城市居住的癌症幸存者的需求和偏好的生存护理计划和沟通的信息。这些信息将帮助我们设计和评估专门设计的护理规划过程，以适应农村居住的幸存者的需求，同时也满足郊区和城市居住的幸存者的需求。