Improving Pain Management in Cancer Care in Latinos

描述（由申请人提供）：本申请建议制定HouseCalls Latino，这是一项针对西班牙裔/拉丁裔癌症患者的基于科学和文化的评估和干预计划。HouseCalls Latino将与英文版的HouseCalls整合。这两个版本都利用了最新的交互式语音应答（IVR）技术，使患者可以在就诊之间指示疼痛和症状水平，并接收常见癌症相关问题的关键教育和自我护理信息。管理应用程序还允许临床医生，研究人员和支持人员访问描述患者疼痛和症状水平随时间变化的可定制报告。该系统旨在解决越来越多的癌症门诊治疗，同时也帮助医疗保健提供者满足新兴的指南，要求疼痛和症状评估的“个性化”。拉丁裔家庭电话系统的发展将使这些目标成为可能，即使西班牙裔/拉丁裔患者与非西班牙语提供者合作。第一阶段涉及开发该系统核心评估模块的Alpha版本和概念验证研究，以证明产品的可接受性。第二阶段将涉及确认为拉丁裔家庭电话提出的所有评估模块的心理测量特性，以及制作和测试完成的教育和其他病人支持服务。尽管疼痛和其他令人痛苦的症状在癌症患者中非常普遍，但许多研究表明，这些症状严重影响生活质量，但提供者没有充分认识到这些症状，也没有充分记录这些症状。尽管JCAHO和其他监管机构要求疼痛“消除”的新指南已经实施，但提供者正在被众多的疾病管理指南所淹没。西班牙裔癌症患者对改善疼痛管理和姑息治疗的需求更为迫切，他们经常面临文化和语言障碍。通过弥合医疗保健提供者和拉丁美洲癌症患者之间的身体，文化和语言差距，同时使疼痛评估更加准确和具有成本效益，HouseCalls拉丁美洲系统旨在帮助解决这一重要问题。

DESCRIPTION (provided by applicant): This application proposes the development of HouseCalls Latino, a scientifically based and culturally appropriate assessment and intervention program in Spanish for Hispanics/Latinos with cancer. HouseCalls Latino will be integrated with an English version of HouseCalls. Both versions utilize the latest Interactive Voice Response (IVR) technology so that patients can indicate pain and symptom levels in between office visits, as well as receive critical educational and self-care information for common cancer-related problems. An administrative application also allows clinicians, researchers, and support staff to access customizable reports depicting patients' pain and symptom levels over time. The system is designed to address the increasing treatment of cancer on an outpatient basis, while also helping healthcare providers meet emerging guidelines that call for the "routinization" of pain and symptom assessments. The development of the HouseCalls Latino system will make these goals possible even when Hispanic/Latino patients are working with non-Spanish speaking providers. Phase I involved development of Alpha versions of the system's core assessment modules and proof of concept research to demonstrate product acceptability. Phase II will involve confirmation of the psychometric properties of all assessment modules proposed for HouseCalls Latino, as well as production and testing of completed educational and other patient support services. Even though pain and other distressing symptoms are extremely widespread among cancer patients, numerous studies have shown that these symptoms, significantly affecting quality of life, are insufficiently recognized and poorly documented by providers. Although new guidelines by JCAHO and other regulatory agencies requiring the 'routinization' of pain have been implemented, providers are becoming overwhelmed by the multitude of disease management guidelines that are surfacing. This need for improved pain management and palliative care is even more urgent among Hispanic cancer patients, who often face cultural and linguistic barriers. By bridging the physical, cultural, and linguistic gaps between health care providers and Latino cancer patients and simultaneously making pain assessments more accurate and cost-effective, the HouseCalls Latino system is designed to help address this important problem.