Caregivers of Cancer Pain Patients: Coping Intervention

在美国，四分之三的家庭至少有一名家庭成员被诊断患有癌症。在 在大多数这些家庭中，一个或多个成员将负责为癌症患者提供护理。最多50- 这些患者中有80%会有明显的疼痛，大多数没有得到充分的治疗。重要力量如 由诊断相关团体造成的医院外活动和管理式护理的重要力量， 创造了一个现实，家庭和病人发现自己在家里提供非常复杂的护理， 这可能不是他们的偏好。由于存在无法缓解的疼痛，提供这种护理变得更加困难。的 现实情况是，客厅已经成为重症监护室和家庭护理人员疲惫不堪的地方 而且负担很重家庭照顾者对药理学、药物剂量和 评估或治疗疼痛被要求成为全天候护理提供者。注意事项： 重要的是，为了了解我们的医疗保健系统中这一主要的、无偿的部分是如何工作的，以及我们能做些什么， 以最大限度地减少切割的压力。针对癌症疼痛患者的家庭照顾者的研究 有限公司许多值得信赖的工作都集中在癌症患者的疼痛，很少有结果的措施，包括 照顾者大多数研究表明，倾听者会增加情绪上的痛苦。对妇女的影响 癌症患者疼痛对家庭成员生活质量（QOL）的影响尚不清楚， 工具没有被使用。另一个限制研究进展的因素是缺乏一个经过实证验证的 了解癌症患者生活质量个体差异或改善生活质量的概念模型 疼痛的患者。拟议中的研究计划旨在增加有关癌症患者康复的知识 通过使用有效的，特定的生活质量工具和经验验证的压力过程模型。使用 心理教育和应对技能干预的压力过程模型将使用 随机对照设计。护理者/患者配对（n = 300）将被随机分配至标准护理或 标准护理加上应对技能干预。护理人员将参加每周六次的一小时访视，包括 关于疼痛评估、止痛药、副作用、对患者情绪困扰的识别的教学信息 病人，压力管理，与疼痛团队的沟通以及围绕这些主题的角色扮演场景。 将测试干预措施的有效性，并确定潜在的调解人和调解人， 干预的有效性。

Three out of four families in the United States will have at least one family member diagnosed with cancer. In the majority of these families, one or more members will be responsible for providing care to the cancer patient. Up to 50- 80% of these patients will have significant pain, the majority not receiving adequate treatment. Important forces such as the movement out of the hospital created by diagnosis-related groups and the significant force of managed care have created a reality in which families and patients are finding themselves at home providing very complex care when that may not be their preference. The provision of this care is made more difficult by the presence of unrelieved pain. The reality is that the living room has become the intensive care unit and the place where family caregivers are exhausted and burdened. Family caregivers who have very little information about pharmacology, dosing of medications, and assessing or treating pain are asked to become around-the-clock care providers. Attention to caregiving issues is important in order to understand how this major, unpaid segment of our health care system works and what we can do to minimize the stress of caregiving. Research focusing on the family caregiver of the cancer patient with pain is limited. Much deseriptive work has focused on the cancer patient with pain, with few outcome measures included for the caregiver. Most work suggests that earegivers have increased emotional distress. The impact of caregiving for cancer patients with pain on family members' quality of life (QOL) remains unclear since valid caregiver-specific QOL instruments have not been used. Another factor limiting research progress is the lack of an empirically validated conceptual model for understanding individual differences in QOL or improving QOL among earegivers of cancer patients with pain. The proposed program of research seeks to increase knowledge about caregiving for cancer patients with pain by using a valid, caregiver-specific QOL instrument and an empirically validated stress process model. Using the stress process model for caregiving, a psychoeducation and coping skills intervention will be evaluated using a randomized, controlled design. Caregiver/patient dyads (n = 300) will be randomly assigned to standard care or standard care plus the coping skills intervention. The caregiver will attend six weekly one-hour visits containing didactic information regarding pain assessment, pain medications, side effects, recognition of emotional distress in the patient, stress management, and communication with the pain team as well as role play scenarios around these themes. The effectiveness of the intervention will be tested as well as identification of potential mediators and moderators of the effectiveness of the intervention.