Ostomy Telehealth Self-management Training for Cancer Survivors

造口术远程医疗癌症幸存者自我管理培训

• 批准号: 10368100
• 负责人: Robert Scott Krouse
• 金额: $ 62.08万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10368100
• 关键词: Address; Affect; Aftercare; Aging; Area; Behavioral; Cancer Survivor; Caregiver support; Caring; Chronic; Chronic Care; Chronic Disease; Cognitive; Communication; Communities; Complex; Computer software; Control Groups; Costs and Benefits; Counseling; Dose; Education; Education Gap; Educational Curriculum; Elderly; Enterostomal Therapy Nurse Specialist; Equipment; Event; Exercise; Face; Family; Fatigue; Fees; Financial Hardship; Frustration; Health Insurance; Health Services Accessibility; Health Status; Healthcare Systems; Insurance Coverage; Knowledge; Length of Stay; Location; Long-Term Care; Malignant Neoplasms; Malignant neoplasm of urinary bladder; Medical; Medical Care Costs; Menu Planning; Methods; Nurses; Operative Surgical Procedures; Ostomy; Pain; Participant; Patients; Persons; Postoperative Care; Postoperative Period; Problem Solving; Rectal Cancer; Rural; Rural Community; Rural Population; Self Care; Self Efficacy; Self Management; Stomas; Survivors; Techniques; Third-Party Payer; Time; Training; Travel; Visit; attentional control; barrier to care; base; behavior change; cancer care; cancer education; cancer therapy; caregiver education; comorbidity; comparison intervention; disability; economic value; evidence base; frailty; health related quality of life; improved; informal caregiver; intervention participants; intervention program; nutrition; operation; patient oriented; peer; programs; psychologic; randomized controlled study; response; rural area; self-management program; service intervention; skills; social situation; support network; survivorship; telehealth; telehealthcare; tool; urinary

Cancer survivors with ostomies, most commonly rectal and bladder cancers, face complex adjustment issues. Typically, post-operative care does not adequately prepare cancer survivors for ostomy self-management, behavior change, psychological support or healthy living, which is requisite to assure optimal Health-Related Quality of Life (HRQOL). We developed an ostomy nurse and peer ostomate-led post-treatment chronic care- based Ostomy Self-Management Telehealth program (OSMT). This program is an education and support curriculum delivered in the group setting for both cancer survivors and their caregiver/support person. We received positive pilot feasibility results, but encountered major access barriers in patients getting to a centralized location to participate in the program. Therefore, we are utilizing telehealth as a delivery method to improve cancer survivor ability to participate. For this study, we will target patients living in rural and other nonmetro areas. The proposal is a randomized controlled study of our self-management program delivered by telehealth intervention compared to an Attention Control Condition (ACC) group. We expect OSMT subjects will improve patient activation, self-efficacy, HRQOL and knowledge via: 1) techniques for self-management to handle frustration, fatigue, pain, isolation, equipment, social situations; 2) overcoming barriers to appropriate exercise; 3) communication skills; 4) nutrition, menu planning, meal timing. In addition, we hope to show a cost benefit to the program, and evidence of reimbursement in the community. Aim 1: Using our enhanced telehealth techniques, determine if patient activation (PA), self-efficacy, ostomy- related knowledge, and HRQOL are improved and sustained over time, comparing OSMT and attention control condition (ACC) groups in rural populations. Aim 2: Determine whether third-party reimbursement for telehealth care encounters are comparable to those for in-person visits and adequate for supporting our OSMT intervention in rural areas.

造口术的癌症幸存者，最常见的是直肠癌和膀胱癌，面临着复杂的调整问题。 通常情况下，术后护理并不能使癌症幸存者为造口术自我管理做好充分准备， 行为改变，心理支持或健康的生活，这是必要的，以确保最佳的健康相关 生活质量（HRQOL）。我们开发了一个造口护士和同行造口领导的治疗后慢性护理- 自我管理远程医疗计划（OSMT）这个项目是一个教育和支持 为癌症幸存者及其照顾者/支持者提供的小组课程。我们 获得了积极的试点可行性结果，但在患者获得 集中的位置来参与该计划。因此，我们正在利用远程保健作为一种交付方法， 提高癌症幸存者的参与能力。在这项研究中，我们将针对生活在农村和其他地区的患者， 非都市区 该提案是一项随机对照研究，我们的自我管理计划交付的远程保健 注意力控制条件（ACC）组。我们预计OSMT科目将有所改善 患者激活，自我效能，HRQOL和知识通过：1）自我管理的技术，以处理 挫折，疲劳，疼痛，孤立，设备，社会情况; 2）克服障碍，适当的锻炼; 3)沟通技巧; 4）营养，菜单规划，用餐时间。此外，我们希望显示出成本效益， 该计划，并在社区报销的证据。 目标1：使用我们增强的远程医疗技术，确定患者激活（PA），自我效能，造口术- 与OSMT和注意力控制相比， 在农村人口中的条件（ACC）组。 目标2：确定第三方对远程医疗保健服务的报销是否与 用于面对面访问，足以支持我们在农村地区的OSMT干预措施。