Health Care Partners in Cancer Prevention & Care of Aged

描述(申请人提供)：为了更好地了解影响老年人癌症预防和癌症护理的因素，我们建议进行一项为期五年的纵向研究，以测试医患健康沟通的“保健伙伴关系”(HCP)模式。我们不仅考虑医患沟通，还考虑消费者及其家人在收集和沟通有关健康的信息时所发挥的积极作用。我们研究了卫生保健伙伴之间的沟通如何影响有关结直肠癌、乳腺癌、前列腺癌和皮肤癌的预防措施的使用。对于被诊断为癌症的受访者，我们还探讨了与医生和照顾者的沟通如何影响生活质量结果。我们把健康传播放在一个生态的背景下(Kreps，2002)，通过考虑结构和个人对健康护理伙伴关系的影响。我们将每年进行四次面对面访问，访问两个具有代表性的社区样本，这些样本是我们先前研究中的老年参与者(N=900)。我们将与年长受访者的医生和非正式健康护理伙伴进行电话访问，以评估他们对癌症预防和护理沟通的倾向。我们将使用自回归和潜在增长曲线结构方程模型(SEM)来评估我们的健康传播的HCP模型中潜在的暂时性和发展性过程。除了使用这些定量方法来深入了解促进老年人癌症预防和护理的因素外，我们还建议对被诊断患有癌症的老年人及其HSO进行深入的定性访谈。通过使用这些多重方法，我们希望发展洞察力，为与老年消费者、与健康相关的其他人以及与医生进行干预提供信息，以增强沟通技能，从而可能有利于患者护理和老年人的生活质量结果。

DESCRIPTION (provided by applicant): To better understand factors influencing cancer prevention and cancer care among elderly persons; we propose a five-year longitudinal study to test a "Health Care Partnership" (HCP) model of doctor-patient health communication. We consider not only doctor-patient communication, but also proactive roles played by consumers and their family members in information gathering and communication concerning health. We examine how communication among health care partners influences use of preventive practices concerning colorectal, breast, prostate, and skin cancers. For respondents diagnosed with cancer, we also explore how communication with doctors and caregivers influences quality of life outcomes. We place health communication in an ecological context (Kreps, 2002) by considering structural and personal influences on health care partnerships. We will conduct four annual face-to-face interviews with two representative community samples of elderly participants in our prior research (N=900). Telephone interviews will be conducted with physicians and informal health care partners of our elderly respondents to assess their orientations to communication about cancer prevention and care. We will use both autoregressive and latent growth curve structural equation models (SEM) to assess potential transitory and developmental processes in our HCP model of health communication. In addition to using these quantitative approaches to gain insights about factors facilitating cancer prevention and care among the aged, we also propose in-depth qualitative interviews with older adults who have been diagnosed with cancer and with their HSOs. Through use of these multiple methods, we hope to develop insights that may inform interventions with elderly consumers, with health significant others, and with physicians to enhance communication skills that may benefit patient care and elderly persons' quality-of-life outcomes.