Emotional Expression and Cancer Caregivers

描述(申请人提供)：针对PA-04-034，癌症控制行为研究探索性拨款，这项两次修订的提案侧重于造血干细胞移植幸存者的配偶照顾者(CG)-与常模和他们的患者同行相比，这些人报告的痛苦程度更高。具体目标是：(1)通过实验操作，确定造血干细胞移植患者的CG是否参与保护性缓冲，即伴侣保护患者免受疾病相关关注或担忧的应对机制，(2)检查配偶CG之间的同步性或缺乏同步性、去同步性，以及(3)测试旨在增强配偶CG的心理和免疫功能的情绪表达(EE)练习的可行性和实施。这项研究将招募117名患者/配偶二人组。患者和CGs将在患者出院后4-6天完成基线评估(问卷)；CGs将提供血样以分析TNF-α和IL-6。然后CGS将被随机分配到三种情况中的一种：患者在场的EE、患者不在的EE或对照条件。对于后者，CGs将谈论积极的体验和时间管理。在所有的会议中，CGs将连续3天进行10分钟的谈话，记录言语和非言语的表达，并收集同步的皮肤电反应。后续评估将在第三次EE会议后立即进行(问卷调查)，并在两个月后再次进行(问卷调查和CG抽血)。R21是对方法和措施的可行性/社会实验室测试，在儿童最需要的时候与其进行干预。这些协调小组缺乏资源。研究结果将决定CGs是否受益于单独和/或在患者面前表达他们的情感的机会。如果正如假设的那样，CGs从在患者缺席的情况下表达的机会中受益，那么未来的研究可以测试这种机会的方法：书面、口头、面对面或互联网。如果CGs受益于在他们的病人面前表达的机会，则可能需要二元干预。简而言之，这项研究的发现可以作为未来研究调查和最终临床干预的跳板。

DESCRIPTION (provided by applicant): This twice revised proposal, in response to PA-04-034, Exploratory Grants for Behavioral Research in Cancer Control, focuses on spousal caregivers (CGs) of hematopoietic stem cell transplant survivors - persons known to report elevated levels of distress as compared to both norms and their patient counterparts. Specific Aims are to: (1) Determine, via experimental manipulation, whether or not CGs of hematopoietic stem cell transplant patients engage in protective buffering, a coping mechanism whereby partners shield patients from illness-related concerns or worries, (2) Examine synchrony or lack thereof, desynchrony, among subjective, expressive and biologic indicators of emotion among spousal CGs, and (3) Test the feasibility and implementation of an emotional expression (EE) exercise designed to enhance psychological and immune functioning among spousal CGs. One-hundred and seventeen patient/ spouse dyads will be recruited for the study. Patients and CGs will complete baseline assessments (questionnaires) 4-6 days after the patient's discharge from the hospital; CGs will provide blood samples to analyze TNF- alpha and IL-6. CGs will then be randomly assigned to one of three conditions: EE with the patient present, EE with the patient absent, or a control condition. For the latter, CGs will talk about positive experiences and time management. For all sessions, CGs will talk for 10 minutes on 3 consecutive days, with verbal and nonverbal expressions recorded and concurrent galvanic skin response collected. Follow-up assessments will occur immediately following the third EE session (questionnaires) and again in two months (questionnaires and CG blood draw). This R21 serves as a feasibility/ social laboratory test of methods and measures, intervening with CGs at their greatest time of need. There exists a lack of resources for these CGs. Findings will determine whether CGs benefit from an opportunity to express their emotions, alone and/or in the presence of their patient. If, as hypothesized, CGs benefit from the opportunity to express in the absence of their patient, future research can test methods for such opportunities: written, verbal, face-to-face or internet. If CGs benefit from the opportunity to express in the presence of their patient, dyadic interventions may be warranted. In short, findings from this study can serve as a springboard for future research investigations and, ultimately, clinical interventions.