Enhancing Survivorship Care Planning for Patients with Localized Prostate Cancer Using A Couple-focused Web-based Tailored Symptom Self-management Program

项目摘要 支持NIH的使命，这个项目旨在探索一种新的护理模式，提高生存护理 计划和促进局部前列腺癌（PCa）患者过渡到治疗后的健康 自我管理由于前列腺癌的高发病率， 美国的前列腺癌发病率，治疗相关副作用的频繁发生和生活质量的降低 (QOL)患者和他们的伴侣（对于伴侣）。新出现的证据表明 使用常规生存护理计划（SCP）并不能改善卫生服务和患者结局， 强制SCP中的内容没有考虑患者的信息和护理需求。我们计划整合一个 以证据为基础，理论驱动的症状自我管理计划，前列腺癌教育和资源 对于夫妇（PERC），与标准化的SCP和构建增强的SCP（ESCP）。ESCPs将使 患者和合作伙伴在生存护理规划，并提供一站式，全面的PERC 计划，以提高他们的生活质量和减少患者使用治疗后护理服务。以夫妻为中心， 基于网络的量身定制的PERC计划包括12个在线模块与任务，一个主持聊天室， 资源中心。根据患者和伴侣的特点和偏好量身定制，以解决他们的特定问题。 护理需求，PERC帮助夫妇减少症状的负面评价，增加获得社会支持， 提高自我效能感和健康行为，促进症状自我管理。在这项研究中，我们建议 测试ESCP（带有PERC网络链接的常规SCP）的可行性，并进行初步效益评估 评估ESCP。我们将使用两组（ESCP=干预，SCP =阴性对照） 随机对照前后测设计，并在基线（T1）和4个月后（T2）收集数据， 50例完成局部PCa初始治疗的患者及其伴侣。具体目标是：目标1： 审查提供ESCP的可行性（根据招聘、入学和保留率进行评估， 对ESCP的满意度，以及感知到的PERC的易用性）。我们将使用混合方法来实现这一目标。 目标2：估计经济、社会和文化权利方案的惠益程度。我们假设，与仅有SCP的用户相比， ESCP使用者将报告（1）他们的QOL的主要结果（总体，身体， 情感和社会生活质量）;（2）次要结局的改善（负面评价减少 以及自我效能、社会支持和健康行为的改善以管理症状）;和（3）更少 T1和T2之间的治疗后护理服务访视。这项研究的结果将有助于设计一个 确定性随机试验，以测试ESCP的疗效。创新的ESCP将加强生存护理 规划并允许广泛和系统地传播PERC，而不需要昂贵的资源 或人员。这个拟议中的项目是为了响应医学研究所和 美国癌症协会，以解决治疗相关的影响，并帮助癌症幸存者保持他们的生活质量。

PROJECT SUMMARY Supporting NIH's mission, this project aims to explore a new model of care that enhances survivorship care planning and promotes health for patients with localized prostate cancer (PCa) transitioning to post-treatment self-management. Survivorship care planning for patients with PCa is important because of the high incidence rates of PCa in the U.S., the frequent occurrence of treatment-related side effects, and reduced quality of life (QOL) in both patients and their partners (for patients who are partnered). Emerging evidence suggests that use of regular survivorship care plans (SCPs) does not improve health service and patient outcomes because the content in mandated SCPs does not consider patients' information and care needs. We plan to integrate an evidence-based, theory-driven symptom self-management program, Prostate Cancer Education & Resources for Couples (PERC), with standardized SCPs and build enhanced SCPs (ESCPs). ESCPs will engage both patients and partners during survivorship care planning and provide a one-stop, comprehensive PERC program to improve their QOL and decrease patient use of post-treatment care services. The couple-focused, web-based tailored PERC program includes 12 online modules with assignments, a moderated chat room and a resource center. Tailored to patients' and partners' characteristics and preferences to address their specific care needs, PERC helps couples reduce negative appraisals of symptoms, increase access to social support, and enhance self-efficacy and health behaviors for symptom self-management. In this study, we propose to test the feasibility of ESCPs (regular SCPs with the PERC web link) and to conduct an initial benefit assessment of ESCPs. We will use a two-group (ESCP=intervention and SCP only=negative control) randomized controlled pretest-posttest design and collect data at baseline (T1) and 4 months later (T2) among 50 patients completing initial treatment for localized PCa and their partners. The specific aims are: Aim 1: Examine the feasibility of delivering ESCPs (as assessed by recruitment, enrollment, and retention rates, satisfaction with ESCP, and perceived ease of use of PERC). We will use mixed methods to achieve this aim. Aim 2: Estimate the magnitude of benefit of ESCPs. We hypothesize that, compared with the SCP only users, the ESCP users will report (1) greater improvement in their primary outcomes of QOL (overall, physical, emotional, and social QOL); (2) greater improvement in secondary outcomes (reduction in negative appraisals and improvement in self-efficacy, social support, and health behaviors to manage symptoms); and (3) fewer visits to post-treatment care services from between T1 and T2. The results from this study will help design a definitive randomized trial to test the efficacy of ESCP. The innovative ESCPs will strengthen survivorship care planning and allow PERC to be disseminated broadly and systematically without the need for costly resources or personnel. This proposed project is in response to calls for programs from the Institute of Medicine and American Cancer Society to address treatment-related effects and help cancer survivors maintain their QOL.