Translation of a Lung Cancer Palliative Care Intervention for Clinical Practice

描述(申请人提供)：肺癌是美国第二常见的癌症，占所有新发癌症病例的55%。它是所有新发癌症病例的第二大原因，但不同性别的第一大死亡原因。在治疗意图不是一个选择的情况下，晚期的表现很常见，姑息治疗成为肺癌患者护理的一个重要方面。跨学科的姑息治疗模式可以有效地将肺癌患者及时地与适当的支持性护理服务联系起来。家庭照顾者(FCG)也集中参与肺癌患者的护理，承担着在疾病发展过程中支持患者的主要责任。这项研究的目的是测试姑息性护理干预(PCI)在非小细胞肺癌(NSCLC)患者及其原发FCG中的传播情况。经皮冠状动脉介入治疗是在希望之城进行的一个项目(P01)中开发和测试的，该项目在大约400名肺癌患者和350名FCG中进行了测试。传播计划将以RE-AIM模式为指导。我们的具体目标包括将干预措施从P01调整到三个姑息治疗研究合作小组(PCRC)地点，并测试干预措施对患者和FCG结果的影响。我们假设，经皮冠状动脉介入治疗将改善患者的生活质量、症状和痛苦，并改善FCGS的负担、痛苦和生活质量。介入治疗由几个部分组成，包括对患者和FCG需求的全面生活质量评估，与跨学科团队一起制定姑息治疗计划，以及患者和FCG教学课程。该应用程序是与PCRC合作开发的，数据管理和分析将在PCRC数据和统计中心进行。它阐述了NINR在RFA中确定的三个广泛领域，包括：1)生物行为研究；2)姑息治疗谱上过渡的影响；以及3)护理问题。

DESCRIPTION (provided by applicant): Lung cancer is the second most common cancer in the United States, accounting for 55% of all new cancer cases. It is the second leading cause of all new cancer cases but the first leading cause of death across genders. In cases where curative intent is not an option, and advanced stages at presentation is common, palliative care becomes an important aspect of care for lung cancer patients. An interdisciplinary palliative care model can effectively link lung cancer patients to the appropriate supportive care services in a timely fashion. Family caregivers (FCG) are also centrally involved in the care of lung cancer patients, assuming primary responsibility for supporting patients across the trajectory of disease. The purpose of this study is to test the dissemination of a Palliative Care Intervention (PCI) for patients with non-small cell lung cancer (NSCLC) and their primary FCG. The PCI was developed and tested in a Program Project (P01) conducted at the City of Hope in approximately 400 lung cancer patients and 350 FCGs. The dissemination plan will be guided by the RE-AIM model. Our specific aims include the adaptation of the intervention from the P01 into three Palliative Care Research Cooperative Group (PCRC) sites, and testing the impact of the intervention on patient and FCG outcomes. We hypothesize that the PCI intervention will improve QOL, symptoms, and distress for patients, and improve burden, distress, and QOL for FCGs. The PCI Intervention consists of several components, and includes a comprehensive QOL assessment of patient and FCG needs, development of palliative care plan with an interdisciplinary team, and patient and FCG teaching sessions. This application has been developed in collaboration with the PCRC, with data management and analysis to be conducted at the PCRC Data and Statistics Center. It addresses the three broad areas identified by the NINR in the RFA including: 1) Bio behavioral research; 2) The impact of transitions along the palliative care spectrum; and 3) Caregiving issues.