Cancer Caregivers and Their Struggle(s) between Work and Family

癌症护理人员及其在工作和家庭之间的挣扎

• 批准号: 10460653
• 负责人: Cathy J Bradley
• 金额: $ 57.67万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10460653
• 关键词: Absenteeism; Address; Adherence; Adjuvant; Affect; Age; American; Anxiety; Biological Markers; Breast Cancer Treatment; Cancer Intervention; Cancer Patient; Caregiver Burden; Caregiver well-being; Caregivers; Caring; Chronic stress; Colorectal Cancer; Computerized Medical Record; Data; Depressed mood; Disabled Persons; Disease; Distress; Drug Prescriptions; Emotional; Employment; Ensure; Equipment and supply inventories; Family; Family Caregiver; Functional disorder; Generations; Hair; Health; Health Insurance; Health Services; Hospitalization; Hour; Hydrocortisone; Inequality; Inflammation; Intervention; Job Satisfaction; Laboratories; Length; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Medical; Mental Depression; Modality; Morbidity - disease rate; Online Systems; Outcome; Outpatients; Participant; Patient Self-Report; Patients; Personal Satisfaction; Persons; Pharmacy facility; Physicians; Physiological; Psychosocial Stress; Randomized; Regulation; Relaxation; Respiration; Risk; Role; Services; Source; Spouses; Stem cell transplant; Stress; Symptoms; System; Telomerase; Testing; Time; Transplant Recipients; Visit; Work; allostatic load; anxious; base; cancer therapy; caregiver interventions; caregiving; comparison intervention; depressive symptoms; emotional distress; evidence base; experience; flexibility; follow-up; health care service utilization; improved; income insurance; loved ones; meetings; mortality; perceived stress; primary caregiver; primary outcome; programs; psychoeducation; psychologic; psychological distress; psychological outcomes; response; secondary outcome; stress management; survivorship; symptom management; symptomatic improvement; telomere; treatment as usual; video chat

This application is in response to FOA “Intervening with cancer caregivers to improve patient health outcomes and optimize heath care utilization” (PAR-16-317) in which we specifically address employed caregivers (CG) and their spousal or partnered cancer patient. Sixty-six million Americans cared for a disabled or ill person in 2015 while CGs of cancer patients represented about 17% of all CGs. Cancer CGs are more distressed than CGs of other medical disorders. Minimal availability of supportive interventions for CGs who care for those with cancer during treatment and afterwards represents an important service disparity. Furthermore, employed cancer CGs must manage multiple responsibilities (the so-called “sandwich generation”) while still caring for their loved-one. Continued employment of the CG may be required for CGs to provide a source of income and/or health insurance for the family. Interventions specifically addressing stress management for cancer CGs have not incorporated unique needs of employed CGs, tracked CG's healthcare utilization as well as emotional and physiological wellbeing. We will test the influence(s) of an evidence-based psychosocial stress management intervention enhanced for employed CGs preselected for greater distress compared to treatment as usual (TAU) on their depression (the CG primary outcome), CG healthcare utilization, and biomarkers of chronic stress. We will allow CGs to select as desired to reduce CG burden from three effective modalities (one-on-one, video chat, or web-based) similar in content as their stress management intervention. This approach allows greater flexibility for the CG to participate in the intervention and thus improve adherence. We will test the extent to which the CG's participation in the intervention compared to TAU also influences the patient's symptom management, distress, and patient healthcare utilization. Emotional distress will be measured using reliable self-reports of psychological depression, anxiety, and stress for both the CG and the patient. Healthcare utilization will use both self-report alongside an available electronic system, COMPASS. COMPASS includes pharmacy use, laboratory results, physician encounters, hospitalizations, and other information also in the electronic medical record. This study will fill an important gap in our understanding of an intervention enhanced for working CGs on improved health outcomes both for themselves as well as for their patient compared to TAU.

此应用程序是为了响应 FOA“干预癌症护理人员以改善患者健康” 结果并优化医疗保健利用率”（PAR-16-317），其中我们专门解决了就业问题 照顾者 (CG) 及其配偶或伴侣癌症患者。六千六百万美国人照顾残疾人 2015 年，癌症患者的 CG 约占所有 CG 的 17%。癌症CG比较多 比其他医学疾病的 CG 更令人苦恼。对于以下情况的 CG 来说，支持性干预措施的可用性最低 癌症患者在治疗期间和治疗后的护理是一个重要的服务差距。 此外，受聘的癌症 CG 必须承担多重责任（所谓的“三明治”） 一代”），同时仍然照顾他们的亲人。可能需要继续雇用 CG，以便 CG 能够 为家庭提供收入来源和/或健康保险。专门针对压力的干预措施 癌症管理 CG 未纳入受雇 CG 的独特需求，跟踪 CG 的医疗保健 利用率以及情绪和生理健康。我们将测试基于证据的影响 针对预选的因更大痛苦而预选的 CG，加强社会心理压力管理干预 与针对抑郁症（CG 主要结局）的常规治疗 (TAU) 相比，CG 医疗保健 利用率和慢性压力的生物标志物。我们将允许 CG 根据需要进行选择，以减少 CG 负担 三种与压力内容相似的有效方式（一对一、视频聊天或基于网络） 管理干预。这种方法为 CG 参与干预提供了更大的灵活性 从而提高依从性。我们将测试CG参与干预的程度 与 TAU 相比，还影响患者的症状管理、痛苦和患者医疗保健 利用率。情绪困扰将通过可靠的心理抑郁、焦虑、 以及 CG 和患者的压力。医疗保健利用将同时使用自我报告和 可用的电子系统，COMPASS。 COMPASS 包括药房使用、实验室结果、医生 电子病历中还包含就诊、住院和其他信息。这项研究将填补 我们对加强工作 CG 干预以改善健康结果的理解存在重大差距 与 TAU 相比，无论是对他们自己还是对他们的患者来说。