DECREASING CHILDREN'S DISTRESS DURING CANCER TREATMENT

儿童癌症的治疗涉及许多侵入性诊断， 和治疗性的医疗程序，这可能是非常紧张的。 虽然在心理治疗方面取得了一些进展， 儿童在这些紧张的医疗程序中的痛苦， 只有在一次事故中， 医疗程序 长期维持治疗益处， 得到了 此外，目前的干预战略需要 在手术过程中有治疗师在场指导儿童，以及 因此，实施起来成本很高。 最后，目前的文献只 开始解决儿童的各种压力经历， 癌 这项研究通过评估一个认知- 行为干预计划，旨在实现长期减少 儿童在各种压力癌症治疗期间的痛苦 通过探索具有成本效益的治疗方案。 六十 将对5至12岁的儿科癌症患者进行分层， 根据年龄，随机分配到以下条件之一：a） 多疗程认知行为治疗与活体治疗师 教练，B）多阶段认知行为治疗， 治疗师和家长指导，或c）等待名单控制。 采用随机三组多波析因设计， 拟议的研究将：1）测试多个会话的认知- 行为治疗计划，其中包括在体内治疗师教练将 导致生理、行为和自我报告的 接受化疗静脉穿刺或注射的儿童的痛苦， 以及骨髓穿刺和腰椎穿刺; 2）测试是否 在教练撤出后，遇险的减少将保持不变; 3）测试 父母是否可以被教导成为孩子的有效教练， 并评估父母培训对孩子和父母的影响。 父母因子女接受治疗而感到痛苦;及4） 比较治疗师辅导与父母辅导的相对有效性 指导实现长期减少儿童的痛苦。

The treatment of childhood cancer involves a number of invasive diagnostic and therapeutic medical procedures which can be extremely stressful. Although some progress has been made in the psychological treatment of children's distress during these stressful medical procedures, existing approaches have only been demonstrated to reduce distress during a single medical procedure. Long-term maintenance of treatment benefits has been obtained. In addition, current intervention strategies require the presence of a therapist to coach the child during the procedure, and therefore, are costly to implement. Finally, the current literature only begins to address the full range of stressful experiences of children with cancer. The proposed study addresses these issues by evaluating a cognitive- behavioral intervention program designed to achieve long-term reductions in children's distress during a variety of stressful cancer treatment procedures, and by exploring cost-effective treatment options. Sixty pediatric cancer patients between the ages of 5 and 12 will be stratified by age and randomly assigned to one of the following conditions: a) multiple session cognitive-behavioral therapy with in vivo therapist coaching, b) multiple session cognitive-behavioral therapy with in vivo therapist and parent coaching, or c) wait list control. By means of a randomized three-group, multi-wave factorial design, the proposed study will: 1) Test whether a multiple session cognitive- behavioral treatment program which includes in vivo therapist coaching will result in decreases in physiological, behavioral, and self-reported distress in children undergoing chemotherapy venopunctures or injections as well as bone marrow aspirations and lumbar punctures; 2) Test whether reductions in distress will maintain after the coach is withdrawn; 3) Test whether parents can be taught to be effective coaches for their children, and evaluate the impact of parent training on both the child's and the parent's distress associated with the child's medical treatment; and 4) Compare the relative effectiveness of therapist coaching versus parent coaching in achieving long-term reductions in children's distress.