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- Registre américain des essais cliniques
- Essai clinique NCT02409485
Improving Self-Management in Head and Neck Cancer
14 janvier 2020 mis à jour par: Hoda Badr, Baylor College of Medicine
By teaching skills to improve the coordination of care and support in couples coping with head and neck cancer (HNC), this couple-based psychosocial intervention holds great promise for improving self-management, reducing costly hospitalizations and treatment interruptions, and improving both partners' quality of life.
Home-based delivery will enhance future dissemination and outreach to those who do not have access to psychosocial services or live far away from their care centers.
If found effective, the intervention may also have salutary downstream effects on the health and well-being of HNC patients and their partners.
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Description détaillée
Patients treated with radiation (XRT) for head and neck cancers (HNCs) experience significant side effects such as abnormally reduced salivation, difficulty swallowing, and taste changes even after they have been definitively treated.
To control side effects and minimize discomfort, intensive self-care protocols are prescribed, but adherence is poor.
Partners (spouses/significant others) can play a critical role in supporting adherence, but often lack knowledge, experience high rates of distress, and display poor communication (e.g., critical or controlling), that can interfere with patient self-care.
The investigators have developed a home-based couples skills-training (CST) intervention that teaches: 1) self-management skills to control/prevent side-effects; 2) communication skills to facilitate coordination of care and support; and 3) strategies to improve communal coping and confidence in the ability to work as a team.
The goal is to reduce healthcare utilization and improve multiple domains of patient and partner QOL.
Specific aims are to: develop and evaluate the content and materials of the CST intervention (AIM 1) and evaluate its feasibility and acceptability (AIM 2).
The multidisciplinary team will review and evaluate the content we have already developed based on the ongoing work with HNC couples (K07).
Once content is finalized, tailored manuals will be developed for patients and partners and evaluated through two focus groups (AIM 1).
The investigators expect that most couples (> 60%) approached will agree to participate and that CST will be well-accepted (AIM 2).
Knowledge gained will be used to refine CST and to collect data on effect sizes and variation for a larger trial.
Innovation: CST takes a multiple-behavioral approach to addressing and preventing HNC treatment side effects and, in the process, seeks to improve multiple domains of QOL.
It is also the first program in HNC that actively involves both members of the couple to address barriers in the home environment in which self-management occurs.
Finally, this study conceptualizes the couple relationship as a resource and leverages that resource to improve patient care and outcomes.
Impact: Home-based delivery will enhance future dissemination and outreach to the target population.
Overall, CST holds great promise for improving patient self-management behaviors, reducing costly hospitalizations and treatment interruptions, and improving multiple aspects of patient and partner QOL.
Type d'étude
Interventionnel
Inscription (Réel)
60
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Texas
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Houston, Texas, États-Unis, 77030
- Baylor College of Medicine
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- patient is initiating radiotherapy for HNC
- patient has Karnofsky score > 50 (ambulatory & capable of self-care)
- patient lives with a partner (spouse/significant other - includes homo- and heterosexual couples)
- patient/partner is able to provide informed consent
- patient/partner is > age 18.
Exclusion Criteria:
- patient has significant comorbidities (e.g., HIV, transplant), or another illness that may require hospitalization
- patient/partner cannot read or communicate using spoken English.
- individuals with diminished mental capacity
- prisoners
- pregnant women
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Soins de soutien
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: Couples Skill-Training (CST)
CST provides education about acute and long-term side-effects of HNC and teaches: 1) self-management skills to control/prevent side-effects; 2) communication skills to facilitate coordination of care; and, 3) strategies to improve communal coping and confidence in the ability to work as a team.
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Patients and partners each receive a workbook and 6 one-hour telephone sessions with a Masters level trained interventionist.
Manual content is tailored based on role (patient or partner).
Couples participate together via speaker phone for half the sessions and patients and partners receive separate (individual) intervention calls for the other half of the sessions.
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Aucune intervention: Usual Medical Care (UMC)
Patients receive standard symptom management education by their health care team.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Feasibility of the CST intervention as assessed by recruitment and retention rates
Délai: 6 months
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recruitment and retention rates
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6 months
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Acceptability of the CST intervention as assessed by the program evaluation questionnaire
Délai: 6 months
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satisfaction with the intervention by completing a program evaluation questionnaire developed by the study team that asks about perceived skills mastery and satisfaction with program content and logistics
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6 months
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
PROMIS short form anxiety and depression
Délai: 6 months
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measures distress with Patient Reported Outcomes Measurement Information System (PROMIS) short form for anxiety and depression
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6 months
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Patient QOL measured by MD Anderson Symptom Inventory - Head and Neck (MDASI-HN)
Délai: 6 months
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measures QOL for patients
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6 months
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Partners QOL measured by Short Form 12 (SF12)
Délai: 6 months
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measures QOL for partners
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6 months
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Short Form Dyadic Adjustment Scale (DAS7)
Délai: 6 months
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measures Relationship functioning
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6 months
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Healthcare utilization as assessed by number of hospitalizations and unplanned clinic visits
Délai: 6 months
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number of hospitalizations and unplanned clinic visits
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6 months
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Hoda Badr, PhD, Icahn School of Medicine at Mount Sinai
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
1 novembre 2014
Achèvement primaire (Réel)
1 octobre 2018
Achèvement de l'étude (Réel)
1 avril 2019
Dates d'inscription aux études
Première soumission
1 avril 2015
Première soumission répondant aux critères de contrôle qualité
3 avril 2015
Première publication (Estimation)
6 avril 2015
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
18 janvier 2020
Dernière mise à jour soumise répondant aux critères de contrôle qualité
14 janvier 2020
Dernière vérification
1 janvier 2020
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- GCO 12-1641
- R21CA178478 (Subvention/contrat des NIH des États-Unis)
- H-48778 (Autre identifiant: Baylor College of Medicine)
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .
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