Caregivers' Strengths-Skills:Managing Older Cancer Patients' Symptoms

描述（由申请人提供）：我们建议实施并评估短期解决问题技能培训计划的有效性，该计划针对低收入老年（60岁以上）治疗后癌症患者的家庭护理人员。干预的目标是使家庭照顾者具备解决问题的技能和知识，为他们提供更适应的手段，以应对他们的老年亲属在癌症生存期可能出现的任何症状。通过关注家庭在治疗后阶段姑息治疗工作中的潜在作用，我们建议我们将能够通过促进增强症状识别，改善症状控制，与卫生专业人员进行宣传以及坚持症状管理选项来影响患者的健康相关生活质量。已完成积极治疗的老年癌症患者的家庭照顾者将从社区/移民健康中心（C/MHCs）获得。护理人员和患者将被随访10个月。具体目标是： (1)提供关于症状管理（“问题解决”）的简短问题解决培训计划，以提高护理人员的技能（即，自我效能感、社会问题解决能力和沟通能力）。 (2)相对于参与护理者支持组（“支持”），评估解决问题在提高护理者技能方面的功效：（a）评估被分配到解决问题条件或支持条件的护理者报告的护理者技能的短期和长期变化;以及（B）相对于那些在支持条件下的护理者的报告，比较在解决问题条件下的护理者报告的变化; (3)评估护理人员技能的变化对以下方面的影响：（a）患者的精神病学和身体功能、抑郁症、焦虑、生活质量、对护理的看法和满意度的变化（“患者结果”）;（B）护理人员的抑郁症、焦虑、生活质量、对患者护理的看法和满意度的变化（“护理人员结果”）。 (4)向参与的C/MHCs和为这些人群服务的其他C/MHCs传播信息，告知缓解和症状控制方面的家庭培训，这取决于展示有益的计划成果。

DESCRIPTION (provided by applicant): We propose to implement and evaluate the efficacy of a short-term problem-solving skills training program for familial caregivers to lower income older (60+) post-treatment cancer patients. The goal of the intervention is to equip family caregivers with problem-solving skills and knowledge that will provide them with a more adaptive means of attending to any symptoms their elderly relative may be experience during the cancer survivorship period. By focusing attention on families' potential role in palliative care efforts during the post-treatment period, we propose that we will be able to impact patients' health related quality of life, by fostering enhanced symptom recognition, improved symptom control, advocacy with health professionals, and adherence to symptom management options. Familial caregivers to older cancer patients who have completed active treatment will be accrued from Community/Migrant Health Centers (C/MHCs). Caregivers and patients will be followed for ten months. The specific aims are to: (1) Deliver a brief problem-solving training program with regard to symptom management ("Problem-solving") to enhance caregiver skills (i.e., perceived self-efficacy, social problem-solving and communication) of familial caregivers to older post-treatment cancer patients. (2) Evaluate the efficacy of problem-solving in enhancing caregiver skills, relative to participating in a caregiver support group ("Support"): (a) Assess short- and long-term change in caregiver skills reported by caregivers assigned to either the Problem-solving condition or the Support condition; and, (b) Compare change reported by caregivers in the Problem-solving condition, relative to reports by those in the Support condition; (3) Assess the impact of change in caregiver skills on: (a) Change in patients' symptomology and physical functioning, depressive symptomology, anxiety, quality of life, perceptions of and satisfaction with care ("patient outcomes"); (b) Change in caregivers' depressive symptomology, anxiety, quality of life, perceptions of and satisfaction with patient care ("caregiver outcomes"). (4) Disseminate information that informs family training in palliation and symptom control to participating C/MHCs and other C/MHCs serving these populations, contingent on demonstrating beneficial program outcomes.