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引起的癌症症状普遍存在。大多数癌症患者在门诊接受治疗，不得不在家中自我控制这些症状。由于各种原因，患者及其护理人员的症状自我管理可能会给他们自己带来巨大的负担，导致患者预后不佳，并由于不必要的住院或诊所就诊而增加医疗保健成本。这个计划的目标是发展一个以家庭为基础的癌症症状管理系统，以促进病人自我管理癌症症状和治疗副作用，并方便护理团队进行远程管理。预期的好处包括改善患者自我报告的结果，更好的自我效能，更好的患者-提供者沟通，减少住院时间/诊所就诊。这是一个快速通道应用程序。我们第一阶段的目标包括：1)通过焦点小组和访谈收集和分析系统需求；2)通过迭代的以用户为中心的设计和面向对象的软件开发方法设计和开发工作原型；3)通过小规模中试评估系统可用性和用户接受度。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开发最终产品，并彻底检查系统架构级别的问题，如性能，可扩展性和可维护性；2)在两个临床地点进行大规模随机对照试验，以评估我们的症状管理方案的疗效。

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.