A Bedside Relational Agent to Improve Hematopoietic Cell Transplantation Outcomes in Cancer Patients

摘要 精神错乱是跌倒的一个主要原因，多达50%的接受干细胞治疗的癌症患者可能会发生精神错乱。 移植，导致高达14倍的死亡机会。精神错乱的风险可以减轻，许多 干细胞移植的其他结果可以通过在 在床边通过对话、图像和音频。然而，提供这些服务的传统方式 干预措施是非常劳动密集型的，很难进行质量控制，而且很难以经济高效的方式扩展到许多人 病人。在这份SBIR快速通道提案中，我们寻求开发一种基于技术的床边数字关系 专为提高癌症患者的幸福感、安全性和预后而设计的试剂 住院患者干细胞移植，通过以下八类方案支持他们：饮食 &水合作用、体育锻炼、激励性肺活量测定、定向、非药理性疼痛和焦虑 管理、心理社会支持和员工沟通、睡眠和如厕协助。到时候我们会的 进行一项为期三年的临床研究，将这一新的干预措施部署到200多名成年患者， 肿瘤科/血液科，旨在观察(与随机对照组相比)统计学意义 住院时间、精神错乱发生率、跌倒发生率、焦虑、抑郁和孤独感减少，并有所改善 患者总体满意度和移植后免疫系统恢复率。这项建议解决了 国家癌症研究所“癌症控制技术(行为健康)”的主要领域 干预)“和”数字健康(移动健康和健康信息技术)“。

Abstract Delirium, a major cause of falls, can occur in as many as 50% of cancer patients undergoing stem cell transplantation, resulting in up to 14 times greater chance of dying. Delirium risk can be mitigated and many other outcomes of stem cell transplants can be improved through behavioral interventions delivered at the bedside through conversation, imagery, and audio. However, traditional means of delivering these interventions are very labor intensive, difficult to quality control, and difficult to cost-effectively scale to many patients. In this SBIR Fast-Track proposal, we seek to develop a technology-enabled bedside digital relational agent specifically programmed to enhance the well-being, safety, and outcomes of cancer patients undergoing inpatient stem cell transplantation, by supporting them through protocols in the following eight categories: Diet & Hydration, Physical Exercise, Incentive Spirometry, Orientation, Non-Pharmacological Pain & Anxiety Management, Psychosocial Support & Staff Communication, Sleep, and Toileting Assistance. We will then conduct a three-year clinical study, deploying this new intervention to over 200 adult patients across two oncology/hematology units, aiming to observe (compared to a randomized control group) statistically significant reductions in length of stay, incident delirium rate, fall rate, anxiety, depression, and loneliness, with improved overall patient satisfaction and rate of immune system recovery post-transplant. This proposal addresses the major National Cancer Institute portfolio areas of “Technologies for Cancer Control (Behavioral Health Interventions)” and “Digital Health (Mobile Health and Health Information Technology).”