Individualized Dual Process Intervention for Bereaved Partners after Cancer Death

癌症死亡后失去亲人的伴侣的个性化双重过程干预

• 批准号: 7887036
• 负责人: Michael S. Caserta
• 金额: $ 7.81万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7887036
• 关键词: Accidents; Address; Adult; Affect; Age; Area; Attention; Awareness; Bereavement; Cancer Etiology; Caregivers; Caring; Case Manager; Case-Control Studies; Cause of Death; Cessation of life; Client; Communication; Communities; Data; Decision Making; Deterioration; Dimensions; Distress; Education; Effectiveness; Effectiveness of Interventions; Elderly; Elements; Emotional; England; Etiology; Event; Funding; Future; Grief reaction; Growth; Home environment; Hong Kong; Hospice Care; Individual; Injury; International; Intervention; Intervention Studies; Lead; Learning; Life; Life Experience; Loneliness; Long-Term Effects; Malignant Neoplasms; Measures; Mediating; Mental Depression; Mental Health; Modeling; Nature; Nurses; Outcome; Outcome Measure; Palliative Care Nursing; Participant; Patients; Personal Satisfaction; Persons; Play; Population; Process; Productivity; Psyche structure; Psychotherapy; Publishing; RQ2; Randomized; Reporting; Research; Research Design; Research Personnel; Resources; Risk; Role; Sampling; Science; Self Care; Self Efficacy; Services; Severities; Sexuality; Social Identification; Source; Spouse Caregiver; Spouses; Stress; Structural Models; Study models; Suggestion; Support Groups; Symptoms; Techniques; Telephone; Terminal Disease; Terminally Ill; Testing; Theoretical model; Therapeutic; Therapeutic Studies; Time; United States National Institutes of Health; Unmarried person; Visit; Work; base; caregiving; compare effectiveness; comparison group; coping; design; end of life; end of life care; expectation; experience; group intervention; hospice environment; improved; insight; interest; knowledge base; meetings; model design; mortality; neglect; physical conditioning; restoration; self help; skills; stressor; symposium; theories; treatment as usual

Individuals providing end-of-life caregiving to partners with terminal cancer often begin the bereavement process with addifional sources of stress. We know that bereavement for these partners can be long-term and impact virtually every aspect of their lives but we know very little about the effectiveness of theoreticallybased interventions to enhance their coping ability and outcomes. This project is unique because we: 1) test the effectiveness of a new promising intervenfion approach based on the dual process model (DPM), 2) use an individually-tailored intervention format that can be compared to a group delivered format from another study, 3) use a sample of spouses/partners age 50+ who used hospice home services for cancer-related deaths, 4) are one of 3 interdependent projects in a P01 application that examines the transition from predeath caregiving to long-term bereavement adaptation and studies the influence of hospice RN case managers on the participants' pre- and post-death coping processes and outcomes. The DPM suggests that bereaved persons need to oscillate between two coping processes, each related to unique sources of stress. Loss-orientation refers to the management of psychoemotional aspects of loss, and restoration-orientation deals with learning new skills of daily living. Primary aims are related to testing the effectiveness of an l-DPM intervention individually delivered to 80 hospice partners bereaved from cancer-related deaths compared to 80 similar bereaved persons in a nontreatment usual care condition. Participants will be randomized into the 2 study conditions from among those in the two other POl projects. Coping and outcome measures are obtained at baseline (2 months bereaved) and immediately after the 14-week intervention, and at 8 and 14 months bereaved. Those in the l-DPM condition are expected to show greater improvement in coping and outcomes than controls or those in the DPM treatment group in our other study. Interdependent aims address relationships between predeath caregiver coping, distress, and RN-caregiver communications and post death bereavement outcomes. The primary statisfical approach will be latent growth curve analyses, augmented by a multilevel explanatory model and other standard parametric techniques.

为患有晚期癌症的伴侣提供临终关怀的个人通常会开始丧亲之痛 具有额外压力来源的过程。我们知道这些合作伙伴的丧亲之痛可能是长期的 并影响他们生活的几乎各个方面，但我们对基于理论的有效性知之甚少 干预措施以提高他们的应对能力和结果。这个项目是独一无二的，因为我们：1）测试 基于双过程模型 (DPM) 的新的有希望的干预方法的有效性，2) 使用 单独定制的干预形式，可以与另一个小组提供的形式进行比较 研究，3) 使用年龄 50 岁以上的配偶/伴侣样本，他们因癌症相关而使用临终关怀家庭服务 死亡人数，4) 是 P01 应用程序中 3 个相互依赖的项目之一，该项目检查从 临终关怀对长期丧亲适应的影响及研究临终关怀注册护士案例的影响 管理人员对参与者死前和死后的应对过程和结果进行评估。副总理建议 失去亲人的人需要在两个应对过程之间摇摆，每个过程都与独特的压力来源有关。 损失导向是指对损失的心理情感方面的管理，而恢复导向是指 涉及学习日常生活的新技能。主要目标与测试 l-DPM 的有效性相关 与癌症相关死亡的 80 名临终关怀伙伴分别进行干预 80 名类似的失去亲人的人处于未接受治疗的常规护理状态。参与者将被随机分配到 2 研究其他两个 POl 项目的条件。应对措施和结果措施是 在基线（失去亲人的 2 个月）和 14 周干预后立即以及第 8 周和第 14 周获得 失去亲人几个月。那些处于 l-DPM 状态的人预计在应对和应对方面会表现出更大的改善。 在我们的另一项研究中，结果优于对照组或 DPM 治疗组。相互依存的目标 解决临终护理人员应对、痛苦和注册护士与护理人员沟通之间的关系， 死后丧亲的结果。主要统计方法将是潜在生长曲线分析， 通过多级解释模型和其他标准参数技术进行增强。