The specific aims of the study are: 1) to examine the effects of a standardized nursing intervention protocol (SNIP) on quality of life and outcomes for post-surgery older cancer patients at. three and six months post-intervention; and 2) to examine the effects of a standardized nursing intervention protocol on the family caregivers' perceived burden at three and six months postintervention. The design is a multifactorial examination of the effects of a short term nursing intervention on quality of life of older cancer patients and their family caregivers. The independent variables are group (experimental intervention vs. standard care) and home care status (home care vs. no home care) and time (baseline, three months and six months). The dependent variables are patient symptom distress, social dependency, depression and mental health status; and family caregiver depression, reactions, physical health and caregiving responsibilities. Additional dependent variables will include patients rehospitalization, medical complications and treatment tolerance. The effects of the intervention will be evaluated using self-report questionnaires administered at pre-treatment and three and six months post-intervention. Additionally, pre-treatment assessments of sociodemographic characteristics, clinical status, cognitive status and co-morbidity will be used to identify patients who are likely to have poorer quality of life post-operatively. Two hundred and eighty eight patients newly diagnosed with lung, breast, colorectal, head and neck, prostate or gynecological cancer 60 years and older, and a family caregiver will be recruited. SNIP will be a short-term nursing intervention targeted at post-surgical patients' symptoms, functional status and mental health status, and the caregiver's physical health and caregiving responsibilities during the first month after hospitalization. Our protocol will include 8 contacts (3 visits and 5 telephone calls) by an oncology clinical nurse specialist (OCNS) and will be scheduled during the acute post-hospital period. The overall analysis to test the study aims will be a multivariate analysis of variance with repeated measures. Means and standard deviations will be computed for quantitative data. Internal consistency and test-retest reliability coefficients for subjects will be computed on the study instruments. Data analyses will include: mean difference analyses, individual differences analyses and outcome analyses.
