Time toxicity of cancer: the time demands of cancer-related activities and their impact on well-being and quality of life

癌症的时间毒性：癌症相关活动的时间需求及其对福祉和生活质量的影响

• 批准号: 10583723
• 负责人: Rachel Isaksson Vogel
• 金额: $ 36.45万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-03 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10583723
• 关键词: Address; Adult; Adverse event; Affect; Age; Area; Cancer Burden; Cancer Patient; Cancer Survivorship; Caring; Categories; Cellular Phone; Cessation of life; Characteristics; Clinical; Combined Modality Therapy; Complex; Data; Data Collection; Data Reporting; Development; Diagnosis; Dimensions; Employment; Face; Family; Future; Goals; Health; Health Technology; Healthcare; Healthcare Systems; Individual; Intervention; Life; Location; Logistics; Machine Learning; Malignant Neoplasms; Malignant neoplasm of ovary; Measures; Metastatic breast cancer; Methods; Mobile Health Application; Modeling; Outcome; Ovarian; Participant; Pathway interactions; Patient Self-Report; Patients; Personal Satisfaction; Play; Population; Prospective, cohort study; Provider; Quality of life; Recommendation; Reporting; Research; Risk; Role; Schedule; Source; Statistical Methods; System; Testing; Time; Toxic effect; Travel; Treatment Protocols; Variant; Wait Time; Work; active method; analytical method; cancer care; cancer therapy; cohort; demographics; experience; flexibility; health care delivery; improved; innovation; loss of function; mHealth; mobile sensing; mobile sensor; neglect; novel; patient variability; premature; psychosocial; rural residence; sensor; shared decision making; side effect; smartphone application; spatiotemporal; standardize measure; therapy design; time use; treatment comparison

Project Summary Cancer care is becoming increasingly complex, with growing demands on patients’ energy and time. As a result, patients often have to neglect their usual life activities and relationships. Such ‘time toxicities’ of cancer are rarely acknowledged and play little role in care considerations. Further, no scoring systems exist to measure the time burden of cancer care. Having to weigh potential survival benefits of treatments against added time burdens especially affects those at risk of premature death. Therefore, there is a critical need to measure and reduce the time toxicities of cancer. The overall objectives of the proposed research are to describe and quantify sources of cancer-related time toxicity among individuals receiving treatment for cancer and their effect on well-being, and to create time toxicity scores which can be used in future studies to identify opportunities to minimize time toxicity. The general hypothesis is that combining sensor-based objective data with subjective self-reported measures of time spent on healthcare-related activities will accurately measure the time burden of cancer care and identify areas for interventions related to treatment delivery to reduce this burden. This hypothesis will be tested via the following specific aims: (1) Measure and describe components of objective time use associated with cancer-related healthcare interactions via a mobile health application; (2) Characterize associations between measures of cancer-related time use and self-reported well-being, and explore the role of context in modifying these associations; (3) Create a time toxicity summary score based on measures of cancer-related time use and assess its association with psychosocial outcomes. We will conduct a 28-day prospective cohort study of 80 individuals with advanced stage ovarian cancer or metastatic breast cancer. Using an existing smartphone application, we will automatically track time spent on daily cancer activities, augmented by participant-reported details on specific activities, well-being (daily), and quality of life (baseline and end of study). We will estimate associations between objective time use and daily well-being, explore variations in these associations by patient characteristics, develop a multidimensional scoring system of time toxicity differentiating between episodic toxicity, travel toxicity, opportunity toxicity, and scheduling toxicity, and measure the associations of these scores with patient reported psychosocial outcomes. Upon completion we will have developed objective measures of daily time use by cancer activity and patient characteristics (Aim 1), estimated associations with daily well-being and explored variations by patient characteristics (Aim 2), and developed a multidimensional time toxicity scoring system (Aim 3). The proposed research is innovative because time toxicity is a novel concept within cancer survivorship which we will capture combining objective sensor data with self-report data. This study will have a significant impact because time matters to patients and our measures of cancer care time burdens will facilitate future interventions to reduce time toxicity.

项目概要 癌症护理变得越来越复杂，对患者的精力和时间的要求也越来越高。作为一个 结果，患者常常不得不忽视他们平时的生活活动和人际关系。癌症的这种“时间毒性” 很少被承认并且在护理考虑中发挥很小的作用。此外，不存在评分系统 衡量癌症护理的时间负担。必须权衡治疗的潜在生存益处 额外的时间负担尤其影响那些有过早死亡风险的人。因此，迫切需要 测量并减少癌症的时间毒性。拟议研究的总体目标是 描述和量化接受癌症治疗的个体中与癌症相关的时间毒性的来源 及其对健康的影响，并创建时间毒性评分，可用于未来的研究来识别 最大限度地减少时间毒性的机会。一般假设是结合基于传感器的客观数据 通过主观自我报告测量花在医疗保健相关活动上的时间将准确测量 癌症护理的时间负担，并确定与治疗提供相关的干预措施以减少这种负担 负担。该假设将通过以下具体目标进行检验：（1）测量和描述 通过移动健康应用程序与癌症相关的医疗保健互动相关的客观时间使用； (2) 描述与癌症相关的时间使用测量与自我报告的幸福感之间的关联，以及 探索背景在改变这些关联中的作用； (3) 根据以下内容创建时间毒性总结评分 测量与癌症相关的时间使用并评估其与心理社会结果的关联。我们将进行 一项为期 28 天的前瞻性队列研究，纳入了 80 名晚期卵巢癌或转移性乳腺癌患者 癌症。使用现有的智能手机应用程序，我们将自动跟踪每天花在癌症上的时间 活动，并通过参与者报告的具体活动、幸福感（每日）和生活质量的详细信息进行补充 （基线和研究结束）。我们将估计客观时间使用与日常福祉之间的关联， 根据患者特征探索这些关联的变化，开发多维评分系统 时间毒性的区别：偶发毒性、旅行毒性、机会毒性和日程安排 毒性，并测量这些分数与患者报告的心理社会结果的关联。之上 完成后，我们将制定癌症活动和患者每日时间使用的客观衡量标准 特征（目标 1）、与日常健康的估计关联以及患者探索的变化 特征（目标 2），并开发了多维时间毒性评分系统（目标 3）。拟议的 研究具有创新性，因为时间毒性是癌症生存中的一个新概念，我们将捕捉到这一点 将客观传感器数据与自我报告数据相结合。这项研究将产生重大影响，因为时间 对患者而言很重要，我们对癌症护理时间负担的衡量将有助于未来的干预措施，以减少 时间毒性。