Expressive Disclosure Program for Colorectal CA Patients

描述(申请人提供)：结直肠癌患者忍受身体衰退干扰社会功能。疲劳、疼痛和肠道问题会影响日常社交活动。性副作用会破坏夫妻关系的亲密关系。对于社交网络减少的老年患者来说，变化会加剧。根据社会认知处理模型，社会支持可以对心理健康产生重大影响，因为它可以促进对癌症经历的认知处理，从而促进情绪适应。然而，副作用可能很难或令人尴尬地讨论；患者可能会避免讨论它们，以避免负面的社会反应。抑制情绪表达会阻碍认知过程，导致心理痛苦。心理问题可能会影响医疗结果，如果不治疗，可能会发展成临床疾病，导致社会孤立和生活质量(QOL)下降。 基于团体的心理社会项目可以通过鼓励情绪表露，从而促进有效的认知处理，有效地改善结直肠癌患者的情绪和社会支持。目前还没有对结直肠癌患者进行支持团体干预的研究。由于支持小组是癌症患者的标准心理社会转介，必须基于健全的理论框架开发有效的小组计划，并且必须确定干预效果的中介。一种名为电子激活记录器(EAR)的新技术被认为是研究这些介体的一种有前途的手段，并克服了自我报告措施的局限性。我们将开发和评估结直肠癌患者表达披露小组计划的可行性，并初步测试EAR技术。如果有效，我们的表现力揭示计划可能为结直肠癌患者提供一种低成本、易于传播的针对心理功能和生活质量的手段。 我们提出了一项由两部分组成的研究，包括一项针对结直肠癌患者的描述性研究，目的是开发表达披露小组计划，以及该计划的一项小型随机可行性研究。研究的两个部分都将招募结直肠癌患者。具体目标是：(1)对结直肠癌患者进行描述性研究，以努力评估与干预形式和后勤有关的生活质量问题和偏好；(2)利用这些信息制定表达披露小组计划；(3)试点测试一种名为EAR的评估社会支持和认知处理的新技术，并将这些数据与自我报告测量进行比较；(4)试点测试表达披露小组计划，并进行过程评估，包括招募和保留率、出勤率、满意度、障碍和随机化的可行性；(5)探讨表达披露团体计划对生活质量结果变量和心理功能的影响，以及对认知加工、应对技能和社会支持的中介变量的影响。

DESCRIPTION (provided by applicant): Colorectal cancer patients endure physical declines which interfere with social functioning. Fatigue, pain, and bowel problems impact routine social activities. Sexual side effects disrupt the intimacy of spousal relationships. Changes intensify for older patients with diminished social networks. According to the Social Cognitive Processing Model, social support can have a significant effect on psychological well-being, as it may facilitate cognitive processing of the cancer experience, thereby promoting emotional adaptation. However, side effects may be difficult or embarrassing to discuss; patients may refrain from discussing them to avoid negative social responses. Inhibiting emotional expression can hinder cognitive processing, resulting in psychological distress. Psychological problems can compromise medical outcomes, and if untreated, can develop into clinical disorders resulting in social isolation and reduced quality of life (QOL). Group-based psychosocial programs may effectively improve mood and social support for colorectal cancer patients by encouraging emotional disclosure, thereby facilitating effective cognitive processing. There has been no study of support group interventions with colorectal cancer patients. Since support groups are a standard psychosocial referral for cancer patients, effective group programs based on sound theoretical frameworks must be developed, and mediators for intervention effectiveness must be identified. A novel technology called the Electronically Activated Recorder (EAR) proposes to be a promising means for studying these mediators and overcomes the limitations of self-report measures. We will develop and assess the feasibility of an Expressive Disclosure Group Program for colorectal cancer patients and pilot test the EAR technology. If effective, our Expressive Disclosure Program may provide a low cost, easily disseminated means for targeting psychological functioning and QOL in colorectal cancer patients. We propose a two-part study including a descriptive study of colorectal cancer patients for the purpose of developing the Expressive Disclosure Group Program and a small randomized feasibility study of this program. A total of 64 colorectal cancer patients will be recruited for both parts of the study. The specific aims are to: (1) conduct a descriptive study of colorectal cancer patients in an effort to assess QOL issues and preferences regarding intervention format and logistics; (2) use the information to develop an Expressive Disclosure Group Program; (3) pilot test a novel technology called the EAR for assessing social support and cognitive processing and compare these data to self-report measures; (4) pilot test the Expressive Disclosure Group Program and conduct process evaluation including rates of recruitment and retention, attendance, satisfaction, barriers and feasibility of randomization; and (5) explore the effects of the Expressive Disclosure Group Program on the outcome variables of QOL and psychological functioning and on the mediating variables of cognitive processing, coping skills, and social support.