BIOBEHAVIORAL CONTROL OF CHEMOTHERAPY SIDE EFFECT

这项申请提出了临床心理学家的研究发展 在控制化疗副作用方面有兴趣和专业知识 使用生物行为学方法。 预期性新生儿和呕吐是发展中的显著副作用， 在接受化疗的患者中， 癌 从心理学，药理学和 神经学研究表明，预期的恶心/呕吐是 习得的或条件性的行为。 充分控制化疗侧 如预期的恶心和呕吐的影响是必不可少的， 最大化癌症治疗效果。 建议的研究是针对优化目前可用的 控制副作用的行为干预，开发新的 恶心评估技术和增加对副作用的了解 影响病因。 为实现这些目标， 加强系统的、综合的副作用控制研究， 建议：（1）随机临床试验，以评估是否 系统脱敏的生物行为治疗在以下情况下同样有效： 由肿瘤学家和肿瘤科护士完成， （2）发展和完善动态生理学 监测患者报告的恶心伴随物;和（3）前瞻性 对预期副作用的病因学研究，以测试 一个8个问题的筛查工具， 化疗治疗，以预测发展的预期方面 方面的影响. 该研究预计， 患者对当前治疗和随机化治疗的依从性 研究试验。

This application proposes research development of a clinical psychologist with interests and expertise in the control of chemotherapy side effects using a biobehavioral approach. Anticipatory neusea and vomiting are significant side effects that develop in approximately 25% of patients receiving chemotherapy treatment for cancer. Converging lines of evidence from psychologic, pharmacologic and neurologic investigations suggest that anticipatory nausea/vomiting are learned or conditioned behaviors. Adequate control of chemotherapy side effects such as anticipatory nausea and vomiting is essential for maximizing cancer treatment effectiveness. Proposed research is directed toward optimizing currently available behavioral interventions for side effect control, developing a new technology for nausea assessment and an increased understanding of side effect etiology. To achieve these aims, the following career development activities designed to enhance systematic, integrated studies of side effect control are proposed: (1) randomized clinical trials to assess whether the biobehavioral treatment of systematic desensitization is as effective when done by oncologists and oncology nurses as it is when done by behavioral psychologists; (2) development and refinement of ambulatory physiologic monitoring for concomitants of patient-reported nausea; and (3) prospective studies on the etiology of anticipatory side effects to test the ability of an 8-question screening instrument given after a patient's first chemotherapy treatment to predict the development of anticipatory side effects. The research has anticipated long-term benefits in the improvement of patient compliance for both current treatment and randomized treatment research trials.