Abstract
This project will screen patients with cancer who are undergoing a course of chemotherapy for active disease, twice weekly for 6 weeks. Those who report either pain or fatigue at 2 or higher (10 point scale) or either pain or fatigue at a 3 or higher will be randomized to a nurse administered, 8-week, 6-contact problem-solving, self care management nursing intervention. The Intervention assists patients and their caregivers to address and manage three problem domains; symptoms, function (physical role impact and social function), and emotional distress. Problems in each domain are addressed through 4 intervention themes; self-care behaviors, communication with family and providers, information-teaching, and counseling and support. Evidenced-based intervention strategies and guidelines are selected from computer assisted documentation that allows nurses to individualize strategies for implementation and to enhance patient self-efficacy so that strategies are retained following the intervention. Patients are directed to communicate with their family caregivers to assist them to implement interventions at home and to respond to requests for assistance. The second arm of this study is directed to having the patient self manage their own symptoms. Patients and caregivers in both arms of the trial receive the same number telephone contacts. Both arms receive symptom management toolkits. This research will accrue 350 patients from several cancer centers to retain the needed 244 cases (122 per arm) for the final analyses. The primary outcome on which power is calculated is the number of symptoms at 10 weeks. This research builds upon current work which supports the impact of chemotherapy, stage, and presence of pain and fatigue upon the risk of poor outcomes. This intervention can improve the outcomes of patients at high risk. It will provide theoretically based evidence of the "value added" contribution of behavioral interventions towards improving outcomes important to patients and families.
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Principal Investigator
Barbara Given
Co-Investigator
Ruth McCorkle
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