scholarly journals Testing the efficacy of a couple-focused, tailored eHealth intervention for symptom self-management among men with prostate cancer and their partners: the study protocol

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Lixin Song ◽  
Matthew E. Nielsen ◽  
Ronald C. Chen ◽  
Christine Rini ◽  
Thomas C. Keyserling ◽  
...  

Abstract Background Men with localized prostate cancer often experience urinary, sexual, bowel, and hormonal symptoms; general distress; pain; fatigue; and sleep disturbance. For men in an intimate relationship, these symptoms disrupt couples’ relationships and intimacy. The symptoms also reduce quality of life for both men and their partners, who are often their primary caregivers. Management of the negative effects of cancer and its treatment is a significantly under-addressed supportive care need for these men and their intimate partners. To address these unmet supportive care needs, our interdisciplinary team developed and pilot tested the usability and feasibility of an evidence-based, couple-focused, tailored eHealth intervention, “Prostate Cancer Education & Resources for Couples” (PERC). Based on the adapted stress and coping theoretical framework and developed with stakeholder involvement, PERC aims to improve quality of life for both men and their partners by enhancing their positive appraisals, self-efficacy, social support, and healthy behaviors for symptom management. Methods We will test the efficacy of PERC using a population-based, geographically and demographically diverse cohort in a randomized controlled trial. Primary aim: Assess if patients and partners receiving PERC will report greater improvement in their cancer-related quality of life scores than those in the control group (usual care plus the National Cancer Institute prostate cancer website) at 4, 8, and 12 months post-baseline. Secondary aim: Test if patients and partners in PERC will report significantly more positive appraisals and higher levels of coping resources at follow-ups than those in the control group. Exploratory aim: Determine if patient race and ethnicity, education, type of treatment, or couples’ relationship quality moderate the effects of PERC on patient and partner QOL at follow-ups. Discussion This study will provide a novel model for self-managing chronic illness symptoms that impact couples’ relationships, intimacy, and quality of life. It addresses the National Institute of Nursing Research’s goal to develop and test new strategies for symptom self-management to help patients and caregivers better manage their illness and improve quality of life. It also responds to calls for programs from the Institute of Medicine and American Cancer Society to address treatment-related effects and improve survivors’ QOL. Trial registration CT.gov NCT03489057

2021 ◽  
Author(s):  
Lixin Song ◽  
Matthew E. Nielsen ◽  
Ronald C. Chen ◽  
Christine Rini ◽  
Thomas C. Keyserling ◽  
...  

Abstract Background: Men with localized prostate cancer often experience urinary, sexual, bowel, and hormonal symptoms, general distress, pain, fatigue, and sleep disturbance. For men in an intimate relationship, these symptoms disrupt couples’ relationships and intimacy. The symptoms also reduce quality of life of both men and their partners, who are often their primary caregivers. Management of the negative effects of cancer and its treatment is a significantly under-addressed supportive care need for these men and their intimate partners. To address these unmet supportive care needs, our interdisciplinary team developed and pilot tested the usability and feasibility of an evidence-based, couple-focused, tailored eHealth intervention, “Prostate Cancer Education & Resources for Couples” (PERC). Based on the adapted stress and coping theoretical framework and developed with stakeholder involvement, PERC aims to improve quality of life for both men and their partners by enhancing their positive appraisals, self-efficacy, social support, and healthy behaviors for symptom management.Methods: We will test the efficacy of PERC using a population-based, geographically and demographically diverse cohort in a randomized controlled trial. Primary Aim: Assess if patients and partners receiving PERC will report greater improvement in their cancer-related quality of life scores than those in the control group (usual care plus the National Cancer Institute prostate cancer website) at 4, 8, and 12 months post-baseline. Secondary Aim: Test if patients and partners in PERC will report significantly more positive appraisals and higher levels of coping resources at follow-ups than those in the control group. Exploratory Aim: Determine if patient race and ethnicity, education, type of treatment, or couples’ relationship quality moderate the effects of PERC on patient and partner QOL at follow-ups..Discussion: This study will provide a novel model for self-managing chronic illness symptoms that impact couples’ relationships, intimacy, and quality of life. It addresses the National Institute of Nursing Research’s goal to develop and test new strategies for symptom self-management to help patients and caregivers better manage their illness and improve quality of life. It also responds to calls for programs from the Institute of Medicine and American Cancer Society to address treatment-related effects and improve survivors’ QOL..Trial registration: CT.gov ID: NCT03489057


Background: Integrated disease management with self-management for Chronic Obstructive Pulmonary Disease (COPD) is effective to improve clinical outcomes. eHealth can improve patients’ involvement to be able to accept and maintain a healthier lifestyle. Eventhough there is mixed evidence of the impact of eHealth on quality of life (QoL) in different settings. Aim: The primary aim of the e-Vita-COPD-study was to investigate the effect of use of eHealth patient platforms on disease specific QoL of COPD patients. Methods: We evaluated the impact of an eHealth platform on disease specific QoL measured with the clinical COPD questionnaire (CCQ), including subscales of symptoms, functional state and mental state. Interrupted time series (ITS) design was used to collect CCQ data at multiple time points. Multilevel linear regression modelling was used to compare trends in CCQ before and after the eHealth intervention. Results: Of 742 invited COPD patients, 244 signed informed consent. For the analyses, we only included patients who actually used the eHealth platform (n = 123). The decrease of CCQ-symptoms was 0,20% before the intervention and 0,27% after the intervention; this difference was statistically significant (P=0.027). The decrease of CCQ-mental was 0,97% before the intervention and after the intervention there was an increase of 0,017%; this difference was statistically significant (P=0,01). No significant difference was found in the slopes of CCQ (P=0,12) and CCQ-function (P=0,11) before and after the intervention. Conclusion: The e-Vita eHealth platform had a potential beneficial impact on the CCQ-symptoms of COPD patients, but not on functional state. The CCQ-mental state remained stable after the intervention, but this was a deterioration compared to the improving situation before the start of the eHealth platform. In conclusion, this study shows that after the introduction of the COPD platform, patients experienced fewer symptoms, but their mental state deteriorated slightly at the same time. Therefore, health care providers should be aware that, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Renzi ◽  
G Gasperini ◽  
V Baccolini ◽  
C Marzuillo ◽  
C De Vito ◽  
...  

Abstract Background Promoting self-care is one of the most promising strategies to manage people with chronic conditions and to improve the Public Health System resilience. In this context, the use of e-Health could facilitate self-care promotion, assure continuity of care and save time. Methods We performed an umbrella review on Cochrane, Scopus, Medline, PsychInfo, CINAHL to analyse e-Health self-care promoting intervention in patients with Type- 2 Diabetes Mellitus (T2DM), Cardiovascular Diseases (CVD) and Chronic Obstructive Pulmonary Disease (COPD) compared to traditional intervention. AMSTAR-2 was used for quality appraisal. Results 10 systematic reviews were included for an amount of 376 RCTs and 3 quasi-experimental studies. All the e-Health interventions retrieved were categorized in 4 subgroups: Phone Reminder, Telemonitoring, Psychoeducational intervention supported by PCs/Apps and Combined Intervention. Nurses (271/379 studies) and physicians (149/379 studies) were the healthcare workers mostly involved in the administration of e-Health interventions. T2DM (5 reviews; 175 studies) and CVD (7 reviews; 164 studies) patients gained more progresses in self-management than COPD patients (3 reviews; 8 studies). E-Health appeared effective both in promoting self-management and disease awareness. Globally, all the e-Health interventions seemed to improve Quality of Life and clinical outcomes. Phone reminders were most effective to increase Medication Adherence. All Causes Mortality registered a positive effect through Telemonitoring. Hospital Admission and Cost-Efficacy were explored only by telemonitoring and it did not show differences with traditional intervention. Conclusions E-Health is an effective strategy to promote self-care in patients with chronic conditions and to improve quality of life and clinical outcomes. Further research is required to test e-Health intervention in COPD patients and to examine if there is different efficacy among e-Health subgroups. Key messages E-Health should be integrated in Primary Care strategies to improve Public Health systems resilience. Nurses, as frontline Primary Health Care workers, should be advised for e-Health administration.


2020 ◽  
Vol 16 (1) ◽  
pp. 53-58
Author(s):  
Shima Rouhi ◽  
Payman Dadkhah ◽  
Manijeh Firoozi ◽  
Masoud Hashemi

Background: Several psychological interventions have been implemented to manage chronic pain. In this study, in addition to the patients, his/her spouses have participated in the program. Besides, this innovative therapy integrates several practical approaches into one comprehensive protocol. Objective: This study aimed to analyze the effectiveness of couple therapy (patient/caregiver-oriented) on improving the quality of life and reducing pain among patients with chronic pain. Methods: The present study is a quasi-experimental and clinical trial with a control group with pretest and posttest. The authors conducted this study at LABAFINEJAD Hospital in Tehran on 30 patients with chronic pain and their spouses by having a short form of a questionnaire for quality of life and chronic pain score questionnaire to measure the effectiveness of the treatment. Results: The results indicated that this treatment increased two aspects of quality of life remarkably, social function and strength for continuing the performance; that help boosts interpersonal relationships as well. Regarding the results, although the couple-based treatment could improve all aspects of pain, the two primary subscales, physical health and mental health, both enhanced. Besides, the treatment reduced the intensity of pain. Conclusion: Couple-based intervention through increasing social support, improving the quality of sex, decentralizing of pain, and paying attention to the neglected needs of caregivers and patients with chronic pain can improve quality of life and reduce pain in patients.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Saowaluck Sukpattanasrikul ◽  
Supreeda Monkong ◽  
Sirirat Leelacharas ◽  
Orapitchaya Krairit ◽  
Chukiat Viwatwongkasem

PurposeThis study aims to examine the effects of a self-management program (SMP) on self-care behavior, blood pressure and quality of life among older adults with uncontrolled hypertension.Design/methodology/approachA quasi-experimental design with repeated measures was conducted in two primary care units in Krabi, Thailand. One hundred and fifty-six older adults with uncontrolled hypertension were selected based on the inclusion criteria and divided into experimental and control groups with 78 participants in each. The experimental group received the SMP, including the intervention related to the self-management process (from the 1st to 4th weeks) and a follow-up phase (from the 5th to 16th weeks). The control group received standard care. The outcomes were measured over time, including self-care behavior (baseline, 4th and 16th weeks), blood pressure (baseline, 4th, 8th, 12th and 16th weeks) and quality of life (baseline and 16th week).FindingsThe generalized estimating equations showed that the SMP, compared with the control group, statistically significantly improved self-care behavior (p < 0.001), decreased blood pressure (p < 0.001) and improved quality of life (p < 0.001) at the 16th week.Originality/valueThe SMP improved the self-care behavior, decreased blood pressure and improved the quality of life among older adults with uncontrolled hypertension. Registered nurses could administer this program for long-term benefits and help reduce the burden on primary care services.


2010 ◽  
Vol 28 (2) ◽  
pp. 134-140 ◽  
Author(s):  
D. McCahon ◽  
E. T. Murray ◽  
K. Murray ◽  
R. L. Holder ◽  
D. A. Fitzmaurice

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