Specialist Palliative Care in Surgical Oncology

肿瘤外科专业姑息治疗

• 批准号: 10263332
• 负责人: Myrick C Shinall
• 金额: $ 23.76万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10263332
• 关键词: Abdomen; Adult; Aging; Automobile Driving; Cancer Death Rates; Cancer Etiology; Cancer Survivorship; Caregiver Burden; Caring; Cessation of life; Clinical; Communication; Consultations; Development Plans; Disease; Elderly; Employment Status; Enrollment; Epidemiology; Excision; Face; Family; Funding; Future; Hospitals; Incidence; Inpatients; Institution; Intervention; Interview; Investigation; Leadership; Life; Literature; Long-Term Care; Malignant Neoplasms; Malignant neoplasm of pancreas; Measures; Medical Oncologist; Mentors; Mentorship; Multivariate Analysis; Nurse Practitioners; Operative Surgical Procedures; Outcome; Outpatients; Palliative Care; Participant; Patient Care; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Perception; Perioperative; Personal Satisfaction; Phase; Physicians; Population; Postoperative Period; Process; Provider; Qualitative Research; Quality of life; Randomized; Randomized Controlled Trials; Recovery; Research; Research Methodology; Research Personnel; Resort; Single-Blind Study; Specialist; Structure; Surgeon; Surgical Oncology; Time; Training; age related; arm; cancer surgery; cancer therapy; care providers; career; career development; chemotherapy; clinical care; design; end of life; end of life care; experience; follow-up; group intervention; health care service utilization; improved; improved outcome; inclusion criteria; indexing; medical specialties; mortality; multiple chronic conditions; novel strategies; older patient; operation; post-traumatic symptoms; primary endpoint; residence; secondary endpoint; shared decision making; surgery outcome; survivorship; treatment arm; treatment as usual

Early Specialist Palliative Care in Surgical Oncology Abstract For elderly patients, care at the end of life (EOL) is often fragmented, expensive, needlessly aggressive, and insufficient to provide comfort and dignity. Expert palliative care consultation is one strategy to improve EOL care. Involvement of palliative care providers has also been shown to improve clinical and patient-reported outcomes when initiated early in the course of treatment for life-threatening diseases, especially cancer. However, the utility of early palliative care is not well studied in older adults undergoing surgery for cancer. There is a driving unmet need to improve outcomes of patients undergoing surgery for cancer while improving EOL care for those who ultimately succumb to their disease. Early palliative care consultation is a promising strategy to meet this need. The Surgery for Cancer with Option of Palliative Care Expert (SCOPE) Trial will begin to answer the question of whether patients undergoing surgery for cancer will benefit from early palliative care. SCOPE is a randomized controlled trial enrolling 236 patients undergoing resections for malignancies with particularly poor prognoses. In the intervention arm, patients receive a pre-operative consultation with a palliative care provider along with continued inpatient and outpatient palliative care follow-up post-operatively. Control arm patients will receive usual care. The Specific Aims of the SCOPE Trial are to determine: 1) whether the intervention improves physical and functional quality of life at 90 days; 2) whether intervention patients have improved recovery from surgery, cancer survivorship, and end of life care; and 3) whether the intervention patients perceive their care and needs differently. The SCOPE Trial forms part of the career development plan of Dr. Myrick Shinall to mature into an independent researcher of the benefit of palliative care interventions for surgical patients with serious age- related conditions. The SCOPE Trial will provide a platform for Dr. Shinall to launch larger, more intensive investigations of palliative care in older surgical populations. While conducting the trial, Dr. Shinall will also undertake training in epidemiology, qualitative research methods, aging research, and leadership. He will additionally benefit from the guidance of his primary mentor, Dr. E. Wesley Ely, who has maintained independent federal funding for 15 years and has mentored several young investigators to independence in the process. The combination of didactic training, Dr. Ely’s mentorship, and experience gained from conducting the SCOPE trial will allow Dr. Shinall to develop into an independent investigator of palliative care interventions in surgical patients with serious age-related conditions.

外科肿瘤学中的早期专家姑息治疗 摘要 对于老年患者，生命末期（EOL）的护理通常是分散的，昂贵的，不必要的 咄咄逼人，不足以提供舒适和尊严。专家姑息治疗咨询是一种策略， 改善EOL护理。姑息治疗提供者的参与也被证明可以改善临床和 在危及生命的疾病治疗过程早期开始时的患者报告结局， 尤其是癌症。然而，早期姑息治疗在老年人中的效用还没有得到很好的研究， 癌症手术有一个驱动未满足的需求，以改善接受手术的患者的结果， 癌症，同时改善终末期护理那些谁最终死于他们的疾病。早期姑息治疗 协商是满足这一需要的一个有希望的战略。 癌症手术与姑息治疗专家选择（SCOPE）试验将开始回答 接受癌症手术的患者是否会从早期姑息治疗中受益的问题。 SCOPE是一项随机对照试验，入组了236例因恶性肿瘤接受切除术的患者， 尤其是可怜的小女孩。在干预组中，患者接受术前咨询， 姑息治疗提供者沿着，并在术后继续进行住院和门诊姑息治疗随访。 对照组患者将接受常规护理。SCOPE试验的具体目的是确定：1） 干预是否改善了90天时的身体和功能生活质量; 2）干预是否 患者从手术、癌症存活率和临终关怀中的恢复得到改善;以及3） 干预患者对他们的护理和需求有不同的看法。 SCOPE试验是Myrick Shinall博士职业发展计划的一部分，旨在成熟为一名 独立研究人员的好处姑息治疗干预手术患者严重年龄- 相关条件。SCOPE试验将为Shinall博士提供一个平台， 老年外科人群姑息治疗的调查。在进行试验的同时，Shinall博士还将 接受流行病学、定性研究方法、老龄化研究和领导力方面的培训。他将 此外，他还受益于他的主要导师E博士的指导。韦斯利伊利，谁一直坚持 15年来一直获得独立的联邦资助，并指导了几名年轻的调查人员独立工作 过程教学培训、伊利博士的指导以及从指挥中获得的经验相结合 SCOPE试验将使Shinall博士成为姑息治疗干预的独立研究者 手术病人的严重年龄相关的条件。