PREDICTORS OF RELAPSE TO SMOKING IN LUNG CANCER

肺癌复发吸烟的预测因素

• 批准号: 6665196
• 负责人: Edwin B Fisher
• 金额: $ 28.59万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2006-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6665196
• 关键词: anxiety; behavior prediction; behavioral /social science research tag; clinical research; comorbidity; depression; drug addiction; human subject; lifestyle; longitudinal human study; motivation; neoplasm /cancer classification /staging; nicotine; nonsmall cell lung cancer; psychological aspect of cancer; quality of life; relapse /recurrence; smoking; smoking cessation; social support network; tobacco abuse

This project will identify factors to guide improvements in interventions for maintenance of smoking cessation among patients with lung cancer. Review of the previous proposal (submitted 6/1/99) emphasized its inclusion of too many variables and associated lack of focus and questionable feasibility. In this revision, we have reduced the number of measures from 39 to 20 (48% reduction) and focused the research plan more clearly around specifying the roles in cessation and relapse among lung cancer patients of variables found important in general samples of smokers and ex-smokers. Little research has examined these issues, leaving an important gap in knowledge on which to base efforts to sustain smoking cessation in this high priority group, approximately 50% of whom relapse. During mos 4 - 45, we will enroll 344 patients receiving surgical treatment for stage I and II, non-small cell lung cancer and who smoked within 3 mos preceding referral for surgical evaluation. We will follow these patients at 3, 6, 12, and, as available, 24 and 36 mos post surgery (through 57 rnos of project period). Measures will include variables found important in cessation and maintenance in general samples of smokers and that interventions might address - nicotine dependence, healthy lifestyle, depression, anxiety, social support, and seriousness of disease (including stage, comorbidity, and quality of life). Smoking status will be validated by cotinine and CO. Analyses will evaluate the influence of individual variables on relapse to smoking, mediating and moderating effects among variables, and the fit to observed data of a conceptual model in which variables are organized around two pathways, one based on the personality characteristic of Appetitive Motivation (reward seeking) and associated with Appetitive Urges for cigarettes (anticipation of pleasurable consequences), and one based on Aversive Motivation (negative affect reducing) and associated with Aversive Urges (reduction of negative affect). Thus, results will identify individual variables that are important in relapse and that interventions might address, place understanding of these within broader frameworks of contemporary personality theory, and integrate the individual variables with the broader framework as a basis for identifying individuals likely to benefit from different interventions.

该项目将确定因素，以指导改善肺癌患者维持戒烟的干预措施。对前一个提案（1999年6月1日提交）的审查强调，该提案包含了太多的变数，因此缺乏重点，可行性值得怀疑。在这次修订中，我们将测量的数量从39个减少到20个（减少48%），并将研究计划更明确地集中在指定吸烟者和戒烟者一般样本中发现的重要变量在肺癌患者戒烟和复发中的作用。很少有研究探讨这些问题，留下了一个重要的知识差距，在这个高度优先的群体中，大约50%的人复发，努力维持戒烟。在第4 - 45个月期间，我们将入组344例接受手术治疗的I期和II期非小细胞肺癌患者，这些患者在转诊进行手术评估前3个月内吸烟。我们将在术后3、6、12个月以及24和36个月（截至项目期的57个月）（如有）对这些患者进行随访。测量将包括在一般吸烟者样本中发现的对戒烟和维持很重要的变量，以及干预措施可能解决的变量-尼古丁依赖、健康的生活方式、抑郁、焦虑、社会支持和疾病严重性（包括阶段、合并症和生活质量）。吸烟状态将通过可替宁和CO进行验证。分析将评估个体变量对吸烟复发的影响、变量之间的中介和调节效应以及与概念模型观察数据的拟合，其中变量围绕两个途径组织，一种是基于食欲动机的人格特征一个是基于奖励寻求的，与香烟的食欲冲动（预期愉快的后果）相关，另一个是基于厌恶动机（减少负面影响），与厌恶冲动（减少负面影响）相关。因此，研究结果将确定在复发中重要的个体变量，以及干预措施可能解决的问题，将对这些变量的理解置于当代人格理论的更广泛框架内，并将个体变量与更广泛的框架相结合，作为识别可能从不同干预措施中受益的个体的基础。