Virginia Sun1, Elizabeth Ercolano2, Ruth McCorkle2, Marcia Grant3, Christopher S Wendel4, Nancy J Tallman5, Frank Passero6, Sabreen Raza7, Zuleyha Cidav8, Michael Holcomb9, Ronald S Weinstein9, Mark C Hornbrook10, Robert S Krouse11. 1. Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA. Electronic address: vsun@coh.org. 2. School of Nursing, Yale University, New Haven, CT, USA. 3. Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA. 4. University of Arizona, Tucson, AZ, USA. 5. Unaffilated, Wound, Ostomy, and Continence Nurse, Tucson, AZ, USA. 6. Unaffiliated, Patient Stakeholder, Philadelphia, PA, USA. 7. Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA. 8. University of Pennsylvania, Philadelphia, PA, USA. 9. Arizona Telemedicine Program, University of Arizona, Tucson, AZ, USA. 10. Kaiser Permanente Center for Health Research, Portland, OR, USA. 11. Corporal Michael J. Crescenz Veterans Affairs Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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.
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.
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