DECREASING CHILDREN'S DISTRESS DURING CANCER TREATMENT

减少儿童在癌症治疗期间的痛苦

• 批准号: 3197437
• 负责人: LYNNDA Marie DAHLQUIST
• 金额: $ 14.85万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-03-15 至 1996-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3197437
• 关键词: anxiety; child (0-11); child mental health service; cognitive behavior therapy; human subject; human therapy evaluation; neoplasm /cancer diagnosis; parent offspring interaction; pediatric neoplasm /cancer; psychological stressor; relaxation; stress; videotape /videodisc

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bone marrow aspirations and lumbar punctures; 2) Test whether reductions in distress will maintain after the coach is withdrawn; 3) Test whether parents can be taught to be effective coaches for their children, and evaluate the impact of parent training on both the child's and the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.

儿童癌症的治疗涉及许多侵入性诊断 以及治疗性的医疗程序，这可能会带来极大的压力。 尽管在精神疾病的心理治疗方面取得了一些进展 儿童在这些有压力的医疗程序中的痛苦，存在 只有一种方法被证明可以减少痛苦 医疗程序。长期维持治疗福利一直是 获得。此外，目前的干预战略要求 在手术过程中有治疗师在场指导儿童，以及 因此，实施起来代价高昂。最后，目前的文学只有 开始解决儿童的各种压力经历 癌症。 拟议的研究通过评估认知--来解决这些问题 行为干预计划旨在实现长期减少 儿童在各种应激性癌症治疗中的痛苦 程序，并探索具有成本效益的治疗方案。六十 将对5岁至12岁的儿童癌症患者进行分层 按年龄随机分配到下列情况之一：a) 与活体治疗师进行多疗程认知行为治疗 指导，b)体内多疗程认知-行为疗法 治疗师和家长辅导，或c)等待名单控制。 通过随机三组多波析因设计， 拟议的研究将：1)测试多个阶段的认知- 包括体内治疗师指导的行为治疗计划将 导致生理、行为和自我报告的减少 接受化疗、静脉穿刺术或注射的儿童的痛苦 以及骨髓活检和腰椎穿刺术；2)测试是否 在教练退出后，痛苦的减少将保持不变；3)测试 父母能否被教育成为孩子的有效教练， 并评估家长培训对孩子和 父母因子女就医而产生的痛苦； 比较治疗师辅导与家长辅导的相对有效性 在实现长期减少儿童痛苦方面的指导。