Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland.
Trials. 2011 Apr 28;12:103. doi: 10.1186/1745-6215-12-103.
Cancer diseases and their therapies have negative effects on the quality of life. The aim of this study is to assess the effectiveness of case management in a sample of oncological outpatients with the intent of rehabilitation after cancer treatment. Case management wants to support the complex information needs of the patients in addition to the segmented structure of the health care system. Emphasis is put on support for self-management in order to enhance health - conscious behaviour, learning to deal with the burden of the illness and providing the opportunity for regular contacts with care providers. We present a study protocol to investigate the efficacy of a case management in patients following oncology rehabilitation after cancer treatment.
The trial is a multicentre, two-arm randomised controlled study. Patients are randomised parallel in either 'usual care' plus case management or 'usual care' alone. Patients with all types of cancer can be included in the study, if they have completed the therapy with chemo- and/or radiotherapy/surgery with curative intention and are expected to have a survival time >1 year. To determine the health-related quality of life the general questionnaire FACT G is used. The direct correlation between self-management and perceived self-efficacy is measured with the Jerusalem & Schwarzer questionnaire. Patients satisfaction with the care received is measured using the Patient Assessment of Chronic Illness Care 5 As (PACIC-5A). Data are collected at the beginning of the trial and after 3, 6 and 12 months. The power analysis revealed a sample size of 102 patients. The recruitment of the centres began in 2009. The inclusion of patients began in May 2010.
Case management has proved to be effective regarding quality of life of patients with chronic diseases. When it comes to oncology, case management is mainly used in cancer treatment, but it is not yet common in the rehabilitation of cancer patients. Case management in oncology rehabilitation is not well-established in Switzerland. A major challenge of the study will therefore probably be the recruitment of the patients due to the physicians' and patients' scarcely existing awareness of this issue. Trial registrationISRCTN41474586
癌症疾病及其治疗方法会对生活质量产生负面影响。本研究的目的是评估病例管理在癌症门诊患者样本中的有效性,旨在癌症治疗后进行康复。病例管理除了医疗保健系统的分段结构外,还希望满足患者复杂的信息需求。重点放在支持自我管理上,以增强健康意识行为、学习应对疾病负担,并提供与护理提供者定期接触的机会。我们提出了一项研究方案,以调查癌症治疗后接受肿瘤康复的患者中病例管理的疗效。
该试验是一项多中心、两臂随机对照研究。患者被平行随机分为“常规护理加病例管理”或“常规护理”。如果患者已完成具有治愈意图的化疗和/或放疗/手术治疗,且预计生存时间> 1 年,则可纳入所有类型的癌症患者。为了确定与健康相关的生活质量,使用一般问卷 FACT G。使用耶路撒冷和 Schwarzer 问卷测量自我管理与感知自我效能之间的直接相关性。使用慢性病患者评估护理的 5 个方面(PACIC-5A)来衡量患者对护理的满意度。数据在试验开始时和 3、6 和 12 个月时收集。 功效分析显示,需要 102 名患者的样本量。2009 年开始招募中心。2010 年 5 月开始纳入患者。
病例管理已被证明对慢性病患者的生活质量有效。在肿瘤学方面,病例管理主要用于癌症治疗,但在癌症患者的康复中并不常见。在瑞士,肿瘤学康复中的病例管理尚未得到很好的建立。因此,由于医生和患者对这个问题的认识几乎不存在,患者的招募可能是该研究的主要挑战之一。
ISRCTN41474586