Adherence to the HCT Medical Regimen: Influence of Cancer Patient-Cargiver Dyads

项目标题：坚持HCT医疗方案：癌症患者-照顾者双方的影响 PI：Donna M.Posluszny，博士 Donna Posluszny博士的职业目标是开发一个独立的研究计划，专注于 设计和评估新的行为和心理社会干预措施以加强癌症患者家庭 护理者二人组坚持复杂的医疗方案并改善患者身体健康结果的能力。 K23奖项将使Posluszny博士成为医学助理教授和临床医生 心理学家，通过提供医疗保健培训，为实现这一目标采取必要的第一步 癌症研究；行为和心理社会干预在依从性研究领域的发展 癌症；以及进行和分析纵向和介入性临床研究的方法 病人和家庭照顾者二人组。具体地说，五年培训计划包括(1)正规课程；(2) 来自导师和顾问的定期指导；(3)参加研讨会、讲习班和国家 会议；(4)指导性研究；(5)临床实践。结合Posluszny医生的临床 培训，她的指导团队的专业知识，以及匹兹堡大学的研究环境 医学院和匹兹堡大学癌症研究所将推动成功实施 建议的培训计划和研究性学习。该研究计划致力于实施一个 独立的项目，以评估患者和家庭照顾者对复杂的、多成分的术后护理的依从性 造血干细胞移植(HCT)后100天内的发展和 试行以患者和照顾者为中心的心理教育干预，基于以下原则 问题解决疗法，以提高对HCT后药物治疗的依从性。具体目标是(1) 调查患者和照顾者如何划分与遵守 多组分HCT后医疗方案院后出院；(2)关键风险比率的测定 不遵守HCT后医疗方案的因素和与患者健康结局相关的因素； (3)以患者-照顾者为中心的心理教育试点的编制和初步评价 旨在减少不遵守HCT后医疗方案的干预措施。此应用程序用于 国家癌症研究所继续致力于制定了解家庭作用的倡议 在癌症体验和改善患者的健康结果方面，其独特之处在于其对坚持的二元专注。 总而言之，这项研究的结果将促进识别适应性和非适应性二元 坚持HCT后医疗方案的方法，并提供基础和初步数据 进行心理教育干预，以提高HCT患者及其家庭照顾者的依从性，以及 从而改善患者的健康状况。

Project Title: Adherence to the HCT Medical Regimen: Influence of Cancer Patient-Caregiver Dyads PI: Donna M. Posluszny, PhD Dr. Donna Posluszny's career goal is to develop an independent research program focused on designing and evaluating novel behavioral and psychosocial interventions to enhance cancer patient-family caregiver dyads' ability to adhere to complex medical regimens and improve patient physical health outcomes. The K23 award will enable Dr. Posluszny, who is an Assistant Professor of Medicine and a clinical psychologist, to take the necessary first steps towards this goal by providing training in medical regimen research in cancer; behavioral and psychosocial intervention development in the field of adherence research in cancer; and methodologies for conducting and analyzing longitudinal and interventional clinical research with patient and family caregiver dyads. Specifically, the five-year training plan includes (1) formal coursework; (2) regular mentoring from mentors and consultants; (3) participation in seminars, workshops, and national conferences; (4) mentored research; and (5) clinical practice. The combination of Dr. Posluszny's clinical training, the expertise of her mentoring team, and the research environment of the University of Pittsburgh School of Medicine and University of Pittsburgh Cancer Institute will facilitate the successful implementation of the proposed training plan and research study. The research plan is devoted to the implementation of an independent project to evaluate patient and family caregiver adherence to the complex, multicomponent post- hematopoietic stem cell transplantation (HCT) during the first 100 days post HCT and the development and piloting of a patient-caregiver dyad-focused psychoeducational intervention, grounded in the principles of Problem-Solving Therapy, to enhance adherence to the post-HCT medical regimen. Specific aims are (1) investigation of how patients and caregivers divide the responsibilities associated with adherence to the multicomponent post-HCT medical regimen post-hospital discharge; (2) determination of rates of, key risk factors for, and patient health outcomes associated with nonadherence to the post-HCT medical regimen; and (3) development and preliminary evaluation of a pilot patient-caregiver dyad-focused psychoeducational intervention designed to decrease nonadherence to the post-HCT medical regimen. This application addresses the National Cancer Institute's continuing commitment to developing initiatives to understand the role of family in the cancer experience and improve patient health outcomes, and is unique in its dyadic focus on adherence. Collectively, the outcomes of this study will foster the identification of both adaptive and nonadaptive dyadic approaches to adherence to the post-HCT medical regimen and provide the groundwork and preliminary data for a psychoeducational intervention to improve adherence for HCT patients and their family caregivers, and thereby improve patient health outcomes.