Home-Based Cancer Symptom Management

描述（由申请人提供）：由于疾病进展或癌症治疗引起的副作用导致的癌症症状很普遍。大多数癌症患者在门诊接受治疗，不得不在家中自我管理这些症状。由于各种原因，患者及其护理人员的症状自我管理可能对他们自己造成巨大负担，导致不理想的患者结局和由于不必要的住院或诊所就诊而增加的医疗保健成本。本项目的目标是开发一个以家庭为基础的癌症症状管理（CSM）系统，以促进患者对癌症症状和治疗副作用的自我管理，并促进护理团队的远程管理。预期受益包括改善患者自我报告的结局，提高自我效能，改善患者与提供者的沟通，减少住院时间/门诊次数。这是一个快速通道应用程序。我们第一阶段的目标包括：1）透过焦点小组及面谈收集及分析系统需求; 2）透过以用户为中心的设计及以对象为导向的软件开发方法，设计及开发一个工作原型;及3）透过小规模的试验测试，评估系统的可用性及用户的接受程度。我们的第二阶段目标包括：1）通过添加多媒体患者教育内容并通过彻底检查系统架构级别问题（如性能、可扩展性和可维护性）来开发最终产品; 2）在两个临床站点进行大规模随机对照试验，以评估我们的症状管理解决方案的有效性。 公共卫生相关性：拟议的工作旨在改善获得护理的机会，促进患者自我管理，促进医患沟通，最终改善临床结果并降低医疗成本。这一努力具有特别的公共卫生意义，因为随着人口老龄化，肿瘤患者的数量预计会增加，远程医疗技术可以为偏远农村地区的患者以及城市环境中的体弱或残疾患者提供更容易获得的优质护理。此外，基于家庭的症状管理解决方案可以减少不必要的急诊室和诊所就诊，从而降低医疗成本并节省能源。

DESCRIPTION (provided by applicant): Cancer symptoms due to disease progression or side effects caused by cancer treatment are prevalent. Most cancer patients are treated in outpatient settings, having to self-manage these symptoms at home. For a variety of reasons, symptom self-management by patients and their caregivers can be a tremendous burden on themselves, resulting in suboptimal patient outcomes and increased healthcare costs due to unnecessary hospitalizations or clinic visits. The goal of this project is to develop a home-based Cancer Symptom Management (CSM) system to promote patient self-management of cancer symptoms and treatment side effects and facilitate remote management by the care team. The anticipated benefits include improved patient self-reported outcomes, better self-efficacy, better patient-provider communication, and reduced hospital stays/clinic visits. This is a Fast Track application. Our Phase I aims include: 1) the collection and analysis of system requirements via focus groups and interviews; 2) the design and development of a working prototype via iterative user- centric design and object-oriented software development methodologies; and 3) the evaluation of system usability and user acceptance via a small-scale pilot test. Our Phase II aims include: 1) the development of the final product by adding multimedia patient education contents and by thoroughly examining system architecture level issues such as performance, scalability, and maintainability; and 2) a larger-scale randomized controlled trial at two clinical sites to evaluate the efficacy of our symptom management solution. PUBLIC HEALTH RELEVANCE: The proposed work is intended to improve access to care, promote patient self-management, facilitate provider-patient communication, and ultimately improve clinical outcomes and reduce healthcare costs. The effort is of particular public health interest since with the aging population the number of oncology patients is expected to increase and telemedicine technologies could facilitate more accessible quality care for patients in remote rural locations as well as frail or disabled patients in urban settings. In addition, home-based symptom management solutions could reduce unnecessary emergency room and clinic visits, hence reducing healthcare costs as well as conserving energy.