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Donovan, H.
7/1/05-6/30/07
1 R21NR009275-01 NIH
Internet-Based Cancer Symptoms Management: WRITE Symptoms
Many individuals with cancer
experience multiple, co-occurring symptoms that drastically
impair functioning and quality of life. The process of
trying to manage multiple symptoms can be overwhelming to
patients. An innovative approach to patient education has
recently been developed that should facilitate the process of
managing multiple symptoms. This proposal represents the
first phase in the process of applying the representational
approach to a new delivery mode (from in-person interviews to
correspondence via secure internet messaging services) and to a
more complex patient care situation (from management of a
single, pre-determined symptom to multiple, patient-selected
symptoms). We refer to this as a Written Representational
Intervention To Ease Symptoms, or
WRITE symptoms.
The specific aims of this pilot
study, conducted in collaboration with the National Ovarian
Cancer Coalition (NOCC), are to conduct preliminary evaluations
(feasibility, acceptability, and initial efficacy) of WRITE
symptoms with a sample of women with recurrent ovarian
cancer. Subjects will be 90 women experiencing two or more
bothersome symptoms associated with ovarian cancer recruited via
mailed invitations and advertisements on the NOCC website.
Women will be randomly assigned to one of 2 conditions: 1) a
full baseline assessment, WRITE symptoms intervention
group; and 2) a full baseline assessment, modified wait-list
control group. WRITE symptoms will be delivered via
secure messaging services situated on the NOCC website.
Measures of symptom representations, symptom interference with
life activities and quality of life will be completed by all
subjects at baseline and 5 and 9 weeks later. Assessment
of feasibility and acceptability will be conducted during
recruitment, throughout the study period, and after subjects
have completed the study. Should WRITE symptoms
pass initial evaluations of feasibility, acceptability, and
efficacy, knowledge gained from this pilot study will be used to
plan a randomized controlled trial grant application (R01) to
determine the efficacy of the intervention and the potential
mechanism(s) through which the intervention has its effect.
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Donovan, H.
01/01/06 – 06/30/07
Oncology Nursing Society
Symptom Cluster Experienced by Women Across the Ovarian
Cancer Disease Trajectory
This proposed study is the second collaborative project between
the University of Pittsburgh School of Nursing and the Oncology
Nursing Society. The broad objectives of the project are
to contribute to the conceptual, methodological, and clinical
understanding of symptom clusters in cancer patients. The
specific aims of this study are to 1) describe symptom clusters
in women with ovarian cancer at six different phases in the
disease trajectory (women who have no current evidence of
disease (NED) and have never received chemotherapy; women who
have NED and had primary treatment < 5 years ago; women who have
NED and had primary treatment > 5 years ago; women who currently
have NED after one or more recurrences; women on treatment for
recurrent cancer; and women not receiving treatment for
recurrent cancer); and 2) explore whether symptom clusters are
different for women at different phases of the disease
trajectory, and 3) evaluate whether the predominant symptom
cluster in each subset of women is a better predictor of
impaired function and life satisfaction than total symptom
burden. A secondary aim of the study will be to evaluate a
novel approach to symptom cluster information by using
difference scores among pairs of symptoms as the basis for
cluster analysis. The design of this study is an
exploratory, secondary analysis of existing data from a study of
the cognitive and emotional representations of women with a
history of ovarian cancer. Data to be extracted from the
original data set include disease and treatment status at time
of survey; months since diagnosis, months since last treatment;
number of previous chemotherapy regimens; symptom severity,
symptom interference with life activities, life satisfaction,
and demographic information (age, income, ethnicity, marital
status). Data will be analyzed to identify symptom clusters
within subsets of subjects at different phases of the disease
trajectory and to compare symptom clusters between subsets of
subjects.
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