A Pilot Study of a Spiritually-Focused Intervention

描述(由申请人提供)：关于重病患者精神生活的经验数据很少，对于被诊断为转移性黑色素瘤的人来说尤其如此。研究人员和从业者对患有这种疾病的人的精神健康状况知之甚少；精神应对对心理调整、精神调整和身体健康状况结果的影响；或以精神为重点的心理治疗干预在心理和精神健康状况以及健康状况结果方面的潜在好处。由于精神健康可能是重病患者生活质量的一个重要方面，而且作为补充医学实践的一部分，以精神为重点的干预可能是有益的和重要的，因此，对晚期癌症人群的精神和宗教变量进行系统调查是当务之急。拟议的研究将通过两种方式解决文献中的这些差距。首先，它将收集六个月内转移性黑色素瘤患者的描述性数据，以检测精神和宗教健康的变化。预计由于疼痛和疲劳等疾病变量，参与有组织的宗教活动的人数将随着时间的推移而减少。然而，私人实践和精神福祉预计会随着时间的推移而增加，这是因为控制感发生了变化，需要采取替代以问题为中心的应对策略，以及对死亡和依赖精神资源来应对的认识增加。其次，这项研究将对癌症患者进行精神干预的首批随机试验之一。大约150名被诊断为转移性黑色素瘤的患者将被随机分配到三种情况中的一种：精神集中治疗(SFF)、认知行为治疗(CBT)或常规护理对照组(UCC)。SFF和CBT干预措施将包括五次一小时的会议，在确诊时开始，并延长两个月。结果将通过在干预前后进行的全面问卷调查以及作为随访的2个月和4个月的乳胶来衡量心理和精神健康状况以及健康状况(例如，疼痛、疲劳和疾病进展)。问卷将包括标准化的广泛使用的工具和为本研究设计的几个项目。问卷还将把数据与稳定的负担和资源(例如，人口统计数据和乐观等个人态度)和医疗因素(例如，治疗)进行对照。 预计与其他两种情况相比，SFT干预对心理和精神幸福感以及健康状况会有更积极的影响。

DESCRIPTION (provided by applicant): Empirical data on the spiritual lives of the seriously ill are sparse and this is specifically true for people diagnosed with metastatic melanoma. Researchers and practitioners know little about people confronting this illness in terms of their spiritual well-being; the effects of spiritual coping on psychological adjustment, spiritual adjustment, and physical health status outcomes; or the potential benefits of a spiritually-focused psychotherapeutic intervention in terms of psychological and spiritual well-being, and health status outcomes. Because spiritual well-being may be an important aspect of quality of life for the seriously ill, and because spiritually-focused interventions may be beneficial and important to include as part of complementary medicine practices, systematic investigation of spiritual and religious variables in advanced cancer populations is an urgent priority. The proposed study will address these gaps in the literature in two ways. First, it will collect descriptive data across a six-month period for people with metastatic melanoma to detect changes in spiritual and religious well-being. It is expected that involvement in organized religious practices will decrease across time due to illness variables like pain and fatigue. However, private practices and spiritual well-being are expected to increase across time due to shifts in perceived control, the need to adopt alternatives to problem-focused coping strategies, and an increase awareness of mortality and reliance on spiritual resources to cope. Second, this study will conduct one of the first random trials of a spiritually-focused intervention for people coping with cancer. Approximately 150 people diagnosed with metastatic melanoma will be randomly assigned to one of three conditions: spiritually-focused therapy (SFF), cognitive behavioral therapy (CBT), or usual-care control (UCC). Both the SFF and CBT interventions will include five one-hour sessions initiated upon diagnosis and extended across a two-month period. Outcomes will be measured in terms of psychological and spiritual well-being and health status (e.g., pain, fatigue, and disease progression) through a comprehensive questionnaire administered before and after the intervention, and two and four months latex as follow-up. The questionnaire will include both standardized widely used instruments and a few items designed for this study. The questionnaire will also connect data to control for stable burdens and resources (e.g., demographics and personal attitudes like optimism) and medical factors (e.g., treatments). It is expected that the SFT intervention will have a more positive effect on psychological and spiritual well-being and health status relative to the other two conditions.