FAMILY HOME CARE FOR CANCER--A COMMUNITY BASED MODEL

癌症在老年人中的发病率正在增加，但几乎没有。 知道有持续的癌症护理。癌症已经从急性 迅速解决的疾病，通常是死亡的慢性病， 长期治疗可延长生存时间。在老年人中，有一部分 存活的部分可能会在功能受限的情况下度过。这 研究建议描述一种新的癌症诊断，初步和 持续治疗，启动或增加自我护理的限制， 老年人的活动能力、可控性、认知症状与心理健康 以及这些变量如何影响患者的参与、反应和 家庭照顾者的心理健康状况。这项研究考察了 老年癌症的临床病程及其治疗 需要援助，他们的家人的参与，以及正式的 以及提供这种护理的非正式成本。此轨迹以一个 30天前对患者功能的回顾评估 住院，获得分期数据，初步治疗，并继续 在6、12、24和52岁时对患者及其照顾者进行观察 几周。将按顺序累加1,235名患者 为了确保大约800例(200例前列腺，乳腺， 结直肠癌、肺癌)将在观察结束时保留。 本研究建立在我们现有工作的基础上，并扩展了知识来源：L) 检查年龄、合并症、癌症部位、疾病分期和 在癌症诊断前测量的功能与 治疗的进攻性和随后自我护理的局限性， 活动能力、节制和认知；2)与年龄、共病、癌症有关 地点、治疗和功能到家庭参与护理， 他们的反应和心理健康；3)四种癌症的事件 场地及其待遇与正式系统费用和 照顾这些人的家庭承担的非正式费用。 本申请中提出的研究是 为了针对患者特征、癌症部位和 成本设计的处理变量和管理策略 有效的干预措施将改善患者的功能结果 老年癌症患者在家中由家人照顾。

The incidence of cancer is increasing among the elderly and little is known about continuing cancer care. Cancer has shifted from an acute disease with prompt resolution, usually death, to a chronic disease where long-term treatment increases survival time. Among the elderly, a portion of that survival may be spent with limitations in functioning. This research proposes to describe how a new cancer diagnosis, initial and continuing treatment, initiates or adds to limitations in self care, mobility, continence, cognition symptoms, and mental health of elderly patients and how these variables affect the involvement, reactions and mental health of family caregivers. This research examines the impact of the clinical course of cancer and its treatment upon elderly patients' needs for assistance, the involvement of their families, and the formal and informal costs of providing this care. This trajectory begins with a retrospective assessment of patient functioning 30 days prior to hospitalization, obtains staging data, initial treatment, and continues with observations of patients and their caregivers at 6, 12, 24, and 52 weeks. Twelve hundred and thirty-five patients will be accrued in order to assure that approximately 800 cases (200 cases of prostate, breast, colo-rectal, and lung cancer) will be retained at the end observation. This study builds upon our current work and extends knowledge by: l) examining how age, comorbidity, cancer site, stage of disease, and function, measured prior to the cancer diagnosis, relates to the aggressiveness of treatment and to subsequent limitations in self care, mobility, continence and cognition; 2) relating age, comorbidity, cancer site, treatment and functioning to the involvement of families in caring, their reactions, and mental health; 3) how incident cases of four cancer sites and their treatment are related to the formal system costs and informal costs born by families caring for these persons. The research proposed in this application is an essential "next step" in order to target the cluster of patient characteristics, cancer site and treatment variables, and management strategies for the design of cost effective interventions that will improve the functional outcomes for elderly cancer patients cared for by their families at home.