Living Well: A Web-based Intervention to Improve Quality of Life in Rural and Urban Ovarian Cancer Survivors

摘要 在过去的二十年里，我们和其他人记录了慢性和经常使人衰弱的经历， 卵巢癌的生存率可能包括健康相关生活质量（HRQOL）差， 焦虑和抑郁，睡眠不好，疲劳，多种症状/副作用，存在的担忧，以及 一般预后不良。由于HRQOL的许多方面受到影响， 大多数患者的生存率，改善HRQOL的创新方法的开发 并且潜在地改善临床结果是至关重要的。这种需要在以下情况下尤其如此： 在农村地区，妇女可能较少获得诊所支助系统的服务。尽管多个 卵巢癌幸存者所经历的挑战，针对潜在疗效的研究 在提高HRQOL的心理社会干预是非常有限的。在过去几年中 该研究小组开发并试行了一种基于网络的小组会议干预措施， 生活得好（网络增强的生活课程）针对卵巢癌幸存者的关键问题， 从幸存者那里得到的信息。本呈件的总体目标是审查 在一个随机化的研究中，“生活得好”干预与“健康促进”积极对照干预的疗效 在256名已完成初级治疗的卵巢癌幸存者中进行的对照试验， 5-诊断后的几年。我们假设，生活良好干预将有效地改善 HRQOL，减少感知压力（主要结局）和减少抑郁情绪，焦虑， 疲劳（次要结局）。这个应用程序是高度创新的，因为它结合了元素， 以证据为基础的心理社会干预以一种新的方式针对卵巢癌幸存者的需求， 使用最先进的网络和视频会议平台，可以广泛传播，包括 农村幸存者这项工作是高度翻译，因为它是一个直接应用的发现，从机械 压力相关的研究，以测试干预措施，以减少卵巢癌幸存者的压力。的 应用的意义在于，这种干预有可能克服以前的障碍， 实施这种心理社会干预措施，改善HRQOL，从而提供公共卫生 对研究不足和妥协的癌症人群有好处，复发的可能性很高。

Abstract Over the last two decades, we and others have documented the chronic and often debilitating experience of ovarian cancer survivorship which may include poor health related quality of life (HRQOL), elevated anxiety and depression, poor sleep, fatigue, multiple symptoms/side effects, existential concerns, and a generally poor prognosis. Because of compromises to many aspects of HRQOL combined with low rates of survival for the majority of these patients, development of innovative approaches for improving HRQOL and potentially improving clinical outcomes is of paramount importance. This need is particularly true in rural settings where women may have less access to clinic-based support systems. Despite the multiple challenges experienced by ovarian cancer survivors, research targeting the potential efficacy of psychosocial interventions in enhancing HRQOL has been extremely limited. Over the last several years this research team has developed and piloted a web-based group conferencing intervention entitled Living Well (Web-Enhanced Lessons for Living) targeting key concerns of ovarian cancer survivors and developed with input from survivors. The overarching goal of the present submission is to examine the efficacy of the Living Well intervention vs. a Health Promotion active control intervention in a randomized controlled trial in 256 ovarian cancer survivors who have completed primary treatment and are less than 5-years post-diagnosis. We hypothesize that the Living Well Intervention will be efficacious in improving HRQOL, decreasing perceived stress (primary outcomes) and in decreasing depressive mood, anxiety, and fatigue (secondary outcomes). This application is highly innovative because it combines elements of evidence-based psychosocial interventions in a novel way to target the needs of ovarian cancer survivors, using a state-of-the-art web and video conferencing platform that allows wide dissemination, including to rural survivors. This work is highly translational as it is a direct application of findings from mechanistic stress-related research to testing an intervention to reduce stress in ovarian cancer survivors. The significance of the application is that this intervention has the potential to overcome prior barriers to the implementation of such psychosocial interventions and improve HRQOL, thus providing public health benefits to an understudied and compromised cancer population with a high likelihood of recurrence.