PROMOTING SELF HELP--UNDERSERVED WOMENW/BREAST CANCER

拟议的研究扩展了一个成功的护理干预乳腺癌 癌症患者转移到低收入的年轻盎格鲁人和少数民族妇女。的 干预将教会这些妇女不确定性管理， 加强自我照顾和自助行为。本研究的目的 （1）确定不确定性管理的有效性 护士客户经理通过电话提供的干预， 增加癌症知识，加强自我照顾，提倡自助 改善或维持年轻人、低收入者和 收入盎格鲁，非洲裔美国人和墨西哥裔美国人妇女接受 乳腺癌的治疗; 2）确定是否人的因素 （包括教育、不确定性、不确定性管理和 医疗服务满意度）、疾病因素（包括医疗服务类型） 治疗、治疗类型数量、复发、转移，以及 分期），背景因素（包括信息来源，社会 支助、接受治疗的地点和获得治疗的机会）和时间 加强或限制自我照顾/自助活动、癌症知识和生活 癌症治疗期间妇女的质量，以及3）估计成本 干预的有效性。 该设计是2 × 3重复测量设计，具有两个水平， 处理（不确定性管理和自然控制条件）交叉 有三个层次的种族（盎格鲁，非洲裔美国人和墨西哥人， 美国）。在基线和术后4个月和7个月进行测量 基线。干预为期10周，每周提供一次 电话。干预是基于疾病的不确定性 理论和自助模式，描绘了慢性学习反应 疾病经历。干预措施已从原来的修改 专门解决年轻妇女关切的问题。 多变量模型将用于测试干预效果， 效率、变化模式和变化的持久性 四个结果，自我照顾，自助，癌症知识和生活质量。 分析包括测试的直接和相互作用的影响， 分类为个人、疾病和背景变量的变量， 对结果变量有调节或中介作用。成本 有效性分析技术将用于计算 与成本和利用率相关的成果衡量指标的变化 在学科群内。

The proposed study extends a successful nursing intervention for breast cancer patients to low income younger anglo and minority women. The intervention would teach these women uncertainty management as a means of enhancing self-care and self-help behaviors. The purposes of this study are: 1) to determine the effectiveness of an uncertainty management intervention delivered by a nurse-client manager by telephone in increasing cancer knowledge, enhancing self-care, promoting self-help respond, and improving or maintaining life quality among younger, low income anglo, African-American, and Mexican-American women receiving treatment for breast cancer; 2) to determine whether person factors (including education, uncertainty, uncertainty management, and satisfaction with health care), disease factors (including type of medical treatment, number of types of treatments, recurrence, metastases, and staging), contextual factors (including sources of information, social support, place receiving treatment and access to treatment) and time enhance or limit self-care/self-help activities, cancer knowledge and life quality of women during cancer treatment, and 3) to estimate the cost effectiveness of the intervention. The design is a 2 X 3 repeated measures design with two levels of treatment (uncertainty management and natural control condition) crossed with three levels of ethnicity (anglo, African-American and Mexican- American). The measures are taken at baseline and 4 and 7 months post baseline. The intervention runs for 10 weeks and is delivered by weekly telephone calls. The intervention is based on the Uncertainty in Illness Theory and on the Self-Help Model that depicts learned response to chronic illness experience. The intervention has been modified from the original protocol to specifically address concerns of the younger woman. Multivariate models will be used to test for intervention effects, efficiency, pattern of change and durability of change over time relative to four outcomes, self-care, self-help, cancer knowledge and life quality. Analyses includes testing both direct and interactive effects of groups of variables classified as person, disease, and contextual variables that have either a moderation or mediation effect on outcome variables. Cost effectiveness analytic techniques will be used to calculate ratios of change in the outcome measures achieved relative to costs and utilization level within the subject groups.