Depression & Adherence in Head and Neck Cancer

沮丧

• 批准号: 6944952
• 负责人: EILEEN H SHINN
• 金额: $ 7.55万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6944952
• 关键词: behavioral /social science research tag; cancer rehabilitation /care; cancer rehabilitation mental health service; clinical research; cognitive behavior therapy; comorbidity; dental disorder; depression; head /neck neoplasm; health services research tag; human subject; human therapy evaluation; patient oriented research; questionnaires; swallowing; therapy compliance

DESCRIPTION (provided by applicant): The primary purpose of the proposed research is to develop and pilot test an in-home intervention for depression in depressed oropharyngeal cancer patients receiving radiation treatment. The intervention will be comprised of ten sessions, the bulk of which will be delivered over the telephone, supplemented with a cognitive behavioral structured journal. The pilot intervention will also apply cognitive-behavioral techniques to other issues relevant to this patient population, namely alcohol dependence, where relevant, in order to strengthen the depressed patient's support system, the patient's partner or caregiver will also be offered a psychoeducational component on the nature, course, and treatment for depression. A secondary purpose is to determine whether improvement in depression is related to oropharyngeal cancer patient's adherence to rehabilitative regimens, including swallowing exercises to prevent fibrosis of musculature and maintain normalcy of diet, and oral hygiene routines to prevent infections in the oral cavity and osteoradionecrosis. This feasibility study will use a one-group prospective design following 40 depressed oropharyngeal patients from the beginning of radiation treatment until twelve weeks later. Two follow-up assessments are planned, six weeks after baseline when the intervention will be completed, and again six weeks later. Patients' recruitment and refusal rates, satisfaction, questionnaire completion rates, and dropout will be measured. An inferential analysis testing the efficacy of the intervention in reducing depression will compare pre-and post-levels of depression. Secondary outcome variables will include self-control, as specified in Rehm's model of depression and quality of life. Pain, fatigue, and social support will be tested as mediators of the intervention's potential effect on depression levels.

描述（由申请人提供）： 拟议研究的主要目的是开发和试点测试抑郁症患者接受放射治疗的抑郁症的家庭干预。干预将由十个会议组成，其中大部分将通过电话进行，并辅以认知行为结构期刊。试点干预措施还将把认知行为技术应用于与这一患者群体相关的其他问题，即酒精依赖，在相关的情况下，为了加强抑郁症患者的支持系统，还将向患者的伴侣或照顾者提供关于抑郁症的性质、过程和治疗的心理教育部分。第二个目的是确定抑郁症的改善是否与口咽癌患者坚持康复方案有关，包括吞咽练习以防止肌肉组织纤维化和保持正常饮食，以及口腔卫生常规以防止口腔感染和放射性骨坏死。 这项可行性研究将采用单组前瞻性设计，随访40名抑郁口咽部患者，从放射治疗开始到12周后。计划进行两次随访评估，基线后六周，即干预完成时，六周后再次进行。将测量患者的招募和拒绝率、满意度、问卷完成率和脱落率。测试干预措施在减少抑郁症方面的功效的推理分析将比较干预前后的抑郁水平。次要结果变量将包括自我控制，如雷姆的抑郁和生活质量模型所述。疼痛、疲劳和社会支持将作为干预对抑郁水平潜在影响的中介进行测试。