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Caregivers of Cancer Pain Patients: Coping Intervention

癌痛患者的护理人员：应对干预

基本信息

批准号：
7426216
负责人：
SUSAN C MCMILLAN
金额：
$ 7.28万
依托单位：
UNIVERSITY OF SOUTH FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-09-30 至 2007-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7426216
关键词：
Adverse effects Age American Cancer Society Attention Cancer Patient Caregivers Caring Communication Complex Coping Skills Diagnosis Diagnosis-Related Groups Distress Dose Effectiveness Effectiveness of Interventions Expenditure Family Family Caregiver Family member Gender Health Healthcare Systems Home environment Hospitals Hour Individual Differences Intensive Care Units Intervention Knowledge Life Malignant - descriptor Malignant Neoplasms Managed Care Mediating Mediator of activation protein Modeling Movement Neuropathy Non-Malignant Outcome Outcome Measure Outpatients Pain Pain Measurement Pain management Patients Pharmaceutical Preparations Pharmacology Process Provider Psyche structure Quality of life Randomized Rate Relative (related person)Research Role playing therapy Severities Standards of Weights and Measures Stress Symptoms Testing United States Visceral Visit Work base cancer pain caregiving coping design emotional distress exhaust improved instrument interest member preference programs psychoeducation stress management

项目摘要

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.

在美国，四分之三的家庭中至少有一名家庭成员被诊断出患有癌症。在大多数这些家庭的一名或多名成员将负责为癌症患者提供护理。最多 50- 这些患者中 80% 会出现明显疼痛，其中大多数没有接受足够的治疗。重要力量如由诊断相关团体创建的出院运动和管理式医疗的巨大力量已经创造了这样一个现实：家庭和患者发现自己在家中提供非常复杂的护理可能不是他们的偏好。由于存在未缓解的疼痛，提供这种护理变得更加困难。这现实是，客厅已经成为重症监护室，成为家庭护理人员疲惫不堪的地方和负担。家庭护理人员对药理学、药物剂量和药物剂量方面的信息知之甚少评估或治疗疼痛的人员被要求成为全天候护理提供者。护理问题要引起重视对于了解我们医疗保健系统的这个主要的、无偿的部分如何运作以及我们可以做什么非常重要以尽量减少护理压力。研究重点是患有疼痛的癌症患者的家庭护理人员有限的。许多描述性工作都集中在患有疼痛的癌症患者身上，很少包括针对疼痛的结果测量照顾者。大多数研究表明，戴耳者会增加情绪困扰。照顾的影响癌症患者的痛苦对家庭成员的生活质量 (QOL) 的影响仍不清楚，因为有效的护理人员特定的 QOL 没有使用过仪器。限制研究进展的另一个因素是缺乏经过实证验证的用于理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。拟议的研究计划旨在增加癌症患者护理知识通过使用有效的、针对护理人员的 QOL 工具和经过经验验证的压力过程模型来缓解疼痛。使用将使用以下方法评估护理、心理教育和应对技能干预的压力过程模型：随机、对照设计。护理人员/患者二人组 (n = 300) 将被随机分配到标准护理或标准护理加上应对技能干预。护理人员将每周进行六次每次一小时的探访，其中包括有关疼痛评估、止痛药物、副作用、情绪困扰识别的教学信息患者、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，并确定干预措施的潜在调解者和调节者。干预的有效性。