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这种长期的、经常使人虚弱的经历 卵巢癌存活率可能包括较差的健康相关生活质量(HRQOL)，提高 焦虑和抑郁，睡眠不佳，疲劳，多种症状/副作用，存在的担忧，以及 一般预后较差。由于对HRQOL的多个方面做出了妥协，加上低费率 对于这些患者中的大多数来说，改善HRQOL的创新方法的开发 潜在地改善临床结果是至关重要的。这一需求在以下方面尤为真实 在农村环境中，妇女可能较少获得以诊所为基础的支助系统。尽管有多个 卵巢癌幸存者面临的挑战，针对卵巢癌潜在疗效的研究 提高高危人群生活质量的社会心理干预措施极为有限。在过去几年里 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，名为 生活得好(网络增强的生活经验)，目标是卵巢癌幸存者和 在幸存者的投入下开发出来的。本文件的首要目标是审查 生活质量干预与健康促进积极控制干预的疗效比较 256例卵巢癌存活者的对照试验 诊断后5年。我们假设，改善生活质量的干预措施将有效地改善 HRQOL，减少感知的压力(主要结果)，减少抑郁情绪，焦虑， 和疲劳(次要结果)。此应用程序具有很高的创新性，因为它结合了 以一种新的方式以循证的心理社会干预为目标的卵巢癌幸存者的需求， 使用最先进的网络和视频会议平台，允许广泛传播，包括 农村幸存者。这项工作具有很高的翻译性，因为它直接应用了机械论的发现 与压力相关的研究，以测试一种减少卵巢癌幸存者压力的干预措施。这个 应用程序的意义在于，这种干预有可能克服先前的障碍 实施这种心理社会干预措施，改善人权生活质量，从而提供公共卫生 对研究不足和复发可能性高的癌症人群的好处。

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.