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癌症幸存者的造口远程医疗:造口自我管理培训(OSMT)随机试验的设计

Ostomy telehealth for cancer survivors: Design of the Ostomy Self-management Training (OSMT) randomized trial.

作者信息

Sun Virginia, Ercolano Elizabeth, McCorkle Ruth, Grant Marcia, Wendel Christopher S, Tallman Nancy J, Passero Frank, Raza Sabreen, Cidav Zuleyha, Holcomb Michael, Weinstein Ronald S, Hornbrook Mark C, Krouse Robert S

机构信息

Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA.

School of Nursing, Yale University, New Haven, CT, USA.

出版信息

Contemp Clin Trials. 2018 Jan;64:167-172. doi: 10.1016/j.cct.2017.10.008. Epub 2017 Oct 16.

Abstract

PURPOSE

An ostomy adversely affects health-related quality of life (HRQOL) in a diverse population of cancer survivors and their caregivers. Hit-or-miss ostomy care, nurse counseling, and community referral have been the primary modes of self-management education and support in the peri-operative setting. Few evidence-based, systematic ostomy self-management programs are available to ensure optimal post-operative care. This paper describes the study design of a telehealth-based Ostomy Self-management Training (OSMT) program for cancer survivors and their caregivers.

METHODS

The study is a three-year, randomized trial that tests the effectiveness of the OSMT program on survivor activation, self-efficacy, and HRQOL. The intervention integrates goal setting and problem-solving approaches to enhance survivor activation and self-efficacy to carry out ostomy care. The curriculum is delivered via four group sessions administered by trained ostomy certified nurses (WOCNs) and peer ostomates. An additional session is offered to caregivers to address their needs in relation to ostomy care. Telehealth approaches through videoconferencing are used to enhance program delivery to participants in three different geographic areas across two time zones. Participants join sessions via real-time videoconferencing from their homes.

CONCLUSIONS

The OSMT program has high potential to make a positive impact on the unique physical, psychological, social, and spiritual needs of cancer survivors living with a permanent ostomy. The study design, process, and telehealth approach contributes to the success of future dissemination efforts of the intervention into diverse clinical and community settings.

摘要

目的

造口术会对不同人群的癌症幸存者及其护理人员的健康相关生活质量(HRQOL)产生不利影响。在围手术期,随意的造口护理、护士咨询和社区转诊一直是自我管理教育和支持的主要方式。很少有基于证据的系统性造口自我管理项目可用于确保最佳的术后护理。本文描述了一项针对癌症幸存者及其护理人员的基于远程医疗的造口自我管理培训(OSMT)项目的研究设计。

方法

该研究是一项为期三年的随机试验,旨在测试OSMT项目对幸存者激活、自我效能感和健康相关生活质量的有效性。该干预整合了目标设定和问题解决方法,以增强幸存者的激活能力和进行造口护理的自我效能感。课程通过由经过培训的造口认证护士(WOCN)和造口同伴主持的四组课程进行授课。还为护理人员提供了额外的课程,以满足他们在造口护理方面的需求。通过视频会议的远程医疗方法用于加强对两个时区三个不同地理区域的参与者的项目实施。参与者通过实时视频会议在家中参加课程。

结论

OSMT项目极有可能对患有永久性造口的癌症幸存者独特的身体、心理、社会和精神需求产生积极影响。该研究设计、过程和远程医疗方法有助于该干预措施未来在不同临床和社区环境中推广的成功。

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