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Life After Cancer: Examining Survivor Transitions From Specialist to Primary Care

癌症后的生活：检查幸存者从专科护理到初级护理的转变

基本信息

批准号：
7661524
负责人：
SHAWNA V. HUDSON
金额：
$ 12.6万
依托单位：
UNIV OF MED/DENT NJ-R W JOHNSON MED SCH
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-08-01 至 2013-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7661524
关键词：
Acute Disease Address Adult Adverse effects Affect Affective African American Age Attitude Breast Cancer Biology Cancer Center Cancer Survivor Cancer Survivorship Caring Chronic Disease Clinic Clinical Cognitive Community Clinical Oncology Program Cross-Sectional Studies Data Decision Making Demographic Factors Development Diagnosis Doctor of Philosophy Elderly Epidemiology Family Physicians Female Foundations Goals Gynecologist Health Psychology Healthcare Systems Home environment Individual Institute of Medicine (U.S.)Institutes Internist Intervention Interview Knowledge Late Effects Life Long-Term Effects Long-Term Survivors Malignant Neoplasms Malignant neoplasm of prostate Mammography Measures Medical Mentors Methods Modeling Monitoring for Recurrence Nurse Practitioners Office Visits Oncologist Outcome Patient Care Patient Preferences Patients Phase Physician Assistants Physicians Pilot Projects Population President&apos s Cancer Panel Primary Care Physician Primary Health Care Principal Investigator Process Prostate Prostate-Specific Antigen Provider Qualitative Methods Quality of life Recurrence Research Research Methodology Research Personnel Research Support Research Training Risk Factors Role Sampling Screening for cancer Screening procedure Source Specialist Staging Structure Surveys Survivors Testing Training Training Programs Work base cancer care career development community setting design evidence base follow-up male oncology preference primary care setting programs risk perception theories tumor

项目摘要

DESCRIPTION (provided by applicant): The overall goal of this career development application is to enable Dr. Hudson to become an independent researcher in cancer survivorship and primary care research. The numbers of cancer survivors are rapidly increasing. Breast and prostate cancer survival exceeds 75%. More than half of individuals already diagnosed with cancer are expected to survive for more than 5 years. Primary care providers are seen for one out of three cancer care office visits. Primary care foci of care coordination and continuity are necessary for achieving better survivor care. However, research on primary care providers' impact on survivor outcomes is fairly underdeveloped. Two new studies suggest that survivors who see both oncologists and primary care physicians are more likely to receive recommended follow-up care than patients who see one or the other. However, there is no research that examines how patients think about these options for care, their decision making processes or the impact of these factors on receiving follow-up care. Using a combination of interviewing and survey research methodologies, the proposed studies build on each other to (1) explore early stage breast and prostate cancer survivors' attitudes toward primary care for follow-up cancer screening and (2) develop and validate a survey instrument to be implemented in a study that describes primary care usage and assesses cognitive-affective, patient support and demographic factors that affect how survivors use specialists and primary care physicians for follow-up care. The training plan proposed supports this research by providing necessary advanced mentoring and coursework in health psychology, risk perception, decision making, cancer biology and epidemiology. This will enable the PI to effectively conduct the proposed studies and provide a strong, evidence based foundation for later development of a testable intervention that helps survivors more effectively work with primary care providers around their follow-up cancer care. This program of training and research will be critical to identifying common and important quality of life problems faced by survivors and identifying mechanisms and risk factors underlying these problems. Most importantly, the knowledge gained from these studies is essential for development and testing of theory guided interventions that focus on providing new strategies to more effectively address survivor care in the primary care setting.

描述（由申请人提供）：本职业发展申请的总体目标是使哈德逊博士成为癌症生存和初级保健研究的独立研究人员。癌症幸存者的数量正在迅速增加。乳腺癌和前列腺癌的存活率超过75%。超过一半的已诊断为癌症的人预计将存活5年以上。初级保健提供者被视为三分之一的癌症护理办公室访问。初级保健的护理协调和连续性的重点是必要的，以实现更好的幸存者护理。然而，关于初级保健提供者对幸存者结局的影响的研究还相当不发达。两项新的研究表明，同时看肿瘤学家和初级保健医生的幸存者比看一个或另一个的患者更有可能接受推荐的后续护理。然而，没有研究调查患者如何看待这些护理选择，他们的决策过程或这些因素对接受后续护理的影响。使用访谈和调查研究方法的组合，拟议的研究相互建立，以（1）探索早期乳腺癌和前列腺癌幸存者对后续癌症筛查的初级保健的态度，（2）开发和验证将在描述初级保健使用情况并评估认知情感的研究中实施的调查工具，患者支持和影响幸存者如何使用专家和初级保健医生进行后续护理的人口因素。拟议的培训计划通过提供必要的健康心理学、风险认知、决策、癌症生物学和流行病学方面的高级指导和课程来支持这项研究。这将使PI能够有效地进行拟议的研究，并为后来开发可测试的干预措施提供强有力的循证基础，帮助幸存者更有效地与初级保健提供者围绕其后续癌症护理进行合作。这一培训和研究方案对于确定幸存者面临的常见和重要的生活质量问题以及确定这些问题背后的机制和风险因素至关重要。最重要的是，从这些研究中获得的知识是必不可少的理论指导的干预措施，重点是提供新的战略，更有效地解决幸存者护理在初级保健环境的发展和测试。