Disparate MBC Symptom Severity and Management Barriers

描述(由申请人提供)： 拟议计划的主要目的是为申请者提供实现两个近期目标和一个长期目标的手段和结构。她的长期目标是成为一名独立研究员和一个多学科癌症研究团队的负责人，该团队专注于改善姑息治疗中的症状严重程度。为了实现这一目标，她提出了一个培训计划，包括正式的课程作业、定向阅读、研讨会和指导实践，包括定量分析和焦点小组方法的指导以及下文所述的研究。近期目标是[1]加强对低收入和不同种族的MBC患者在症状发生率和症状严重性方面的差异的了解，以及[2]更好地了解患者使用症状管理策略的障碍，并确定这些障碍是否基于收入或种族因素而不同。 为了实现这些目标，候选人将完成两项小型研究，最终形成适合R01申请的更大规模的研究方案。在多德症状管理理论的指导下，第一项研究将量化MBC患者的症状和症状严重程度，并衡量种族和收入状况对症状发生和严重程度的影响。第二项研究将是定性的，使用焦点小组来确定症状管理的潜在障碍。这些研究结果将为更大规模的研究应用和未来减轻姑息治疗中所有患者症状的干预性研究奠定基础。培训和研究活动将在匹兹堡大学癌症研究所(UPCI)、匹兹堡大学医学中心(UPMC)以及匹兹堡大学公共卫生研究生院、医学院和护理学院进行，这是NCI指定的综合癌症中心。支持活动将在耶鲁大学护理学院、哈佛大学和密尔沃基威斯康星大学进行。

DESCRIPTION (provided by applicant): The primary purpose of the proposed plan is to provide the applicant with the means and structure for achieving two immediate goals and one long-term goal. Her long-term goal is to become an independent investigator and leader of a multidisciplinary cancer research team focusing on improving symptom severity in palliative care. To accomplish this goal, she proposes a training program comprising formal coursework, directed readings, seminars, and mentored practicums, including instruction in quantitative analysis and focus-group methodology as well as the studies described below. The immediate goals are [1] to enhance understanding of the difference in symptom occurrence and symptom severity in low income and racially disparate groups of patients with MBC and [2] to better understand the barriers to the use of symptom-management strategies by patients and to determine if these barriers differ based on income or racial factors. In order to accomplish these goals, the candidate will complete two small studies, culminating in a larger study proposal appropriate for an R01 application. Guided by the Dodd Symptom Management Theory, the first study will quantify symptoms and symptom severity among patients with MBC and will measure the influence of race and income status on symptom occurrence and severity. The second study will be qualitative, using focus groups to identify potential barriers to symptom management. The research findings will be foundational to the preparation of a larger research application and future interventional studies for symptom reduction for all patients in palliative care. Training and research activities will take place at the University of Pittsburgh Cancer Institute (UPCI), an NCI-designated Comprehensive Cancer Center; facilities of the University of Pittsburgh Medical Center (UPMC); and the University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Nursing. Supportive activities will take place at the Yale University School of Nursing, Harvard University and through the University of Wisconsin, Milwaukee.