Informal Caregiver Training in Cancer Symptom Management

描述(由申请人提供)：症状管理被认为是老年癌症患者的非正式照顾者有效家庭护理的重要组成部分。然而，大多数照顾者并不相信他们拥有癌症症状管理所需的知识和技能。无法帮助患者缓解癌症症状对照顾者的心理健康造成不利影响。由于护理者和患者之间的相互关系，护理者的减少很可能也会导致患者的减少。本研究旨在探讨体验式症状管理训练对非正式癌症照顾者的自我效能和心理幸福感的影响，以及对患者癌症相关症状的症状苦恼、强度和急救使用的影响。在老年癌症患者住院期间，个性化培训将在他们的床边进行。地点将设在杜克医疗中心的肿瘤科病房。样本将由120个二联体组成，平均分配到治疗组和注意控制组。治疗组的受试者将接受针对癌症症状干预的个性化体验式培训，而注意力控制组的受试者将接受有关照顾者当地社区资源和健康生活习惯的信息。患者数据将在出院前、出院后1周、2周和4周收集。此外，将在出院后1周、2周和4周收集癌症相关症状的紧急护理使用数据。护理者的数据将在培训前和培训后，以及出院后1、2和4周收集。数据分析将使用描述性统计和包括混合模型在内的多变量分析。这项研究是确定在急性护理环境中提供的经验性训练对二联体的影响的第一步。研究结果将被用于设计一项更大规模的随机临床试验，以评估这种干预的成本效益。长期目标是改进和扩展体验式方法，并在急性护理环境中提供这种方法，以教育患有其他慢性病的老年患者的照顾者。通过这样做，护士被提供了一种有效的手段，使非正式的照顾者为家庭护理做好准备，使年长的慢性病患者能够尽可能长时间地呆在舒适的家里。

DESCRIPTION (provided by applicant): Symptom management is identified as an essential component of effective home caregiving by informal caregivers of older cancer patients. However, most caregivers do not feel confident that they have the knowledge and skills needed in cancer symptom management. Inability to assist patients in alleviating their cancer symptoms adversely affects the psychological well-being of caregivers. Because of the reciprocal relationship in a caregiver-patient dyad, caregiver decline is likely to lead to patient decline as well. The specific aims of this experimental, prospective study are to examine the effects of experiential symptom management training on self-efficacy and psychological well-being of informal cancer caregivers, and on symptom distress and intensity and emergency care use for cancer-related symptoms of their patients. The individualized training will be at the bedside of older cancer patients during their hospitalization. The setting will be the oncology wards at Duke Medical Center. The sample will consist of 120 dyads equally assigned in the treatment and attention control groups. Subjects in the treatment group will receive individualized experiential training on interventions for cancer symptoms, while subjects in the attention control group will receive information on caregiver local community resources and healthy lifestyle habits. Patient data will be collected prior to hospital discharge, and at 1, 2, and 4 weeks after discharge. In addition, data on emergency care use for cancer-related symptoms will be collected at 1, 2, and 4 weeks after hospital discharge. Caregiver data will be collected before and after the training, and at 1, 2, and 4 weeks after discharge. Descriptive statistics and multivariate analysis including mixed models will be used for data analysis. This study is the first step in determining the effects of experiential training offered in an acute care setting on the dyad. The study results will be used to design a larger randomized clinical trial to evaluate the cost-effectiveness of this intervention. The long term goal is to refine and expand the experiential approach and offer it in acute care settings to teach caregivers of older patients suffering from other chronic illnesses. In so doing, nurses are offered an effective means to prepare informal caregivers for home caregiving, enabling older, chronically-ill patients to remain as long as possible within the comfort of their homes.