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

项目名称：HCT医疗方案的依从性：癌症患者-护理者配对的影响 PI：Donna M. Posluszny博士 博士Donna Posluszny的职业目标是开发一个独立的研究项目， 设计和评估新的行为和心理社会干预措施，以提高癌症患者家庭 护理人员二人组坚持复杂的医疗方案和改善患者身体健康结果的能力。 K23奖将使Posluszny博士，谁是医学助理教授和临床 心理学家，通过提供医疗方案培训，为实现这一目标迈出必要的第一步 癌症研究;在坚持研究领域的行为和心理社会干预发展 癌症;以及进行和分析纵向和干预性临床研究的方法， 病人和家庭照顾者的组合具体而言，五年培训计划包括（1）正式课程;（2） 导师和顾问的定期指导;（3）参加研讨会、讲习班和国家一级的 会议;（4）指导研究;（5）临床实践。波斯卢斯尼医生的临床经验 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促进成功实施 提出培训计划和研究报告。该研究计划致力于实施一项 独立的项目，以评估病人和家庭照顾者坚持复杂的，多成分后， 造血干细胞移植（HCT）后的前100天内， 以下列原则为基础，试行以病人-照顾者为中心的心理教育干预措施： 问题解决疗法，以提高对HCT后医疗方案的依从性。具体目标是（1） 调查患者和护理人员如何划分与遵守 多组分HCT后医疗方案出院后;（2）确定关键风险的发生率 与HCT后医疗方案不依从性相关的因素和患者健康结局;以及 (3)以病人-照顾者二元为中心的心理教育试点的发展和初步评价 旨在减少HCT后药物治疗方案不依从性的干预。本申请涉及 国家癌症研究所继续致力于发展了解家庭作用的倡议， 在癌症的经验和改善病人的健康结果，是独特的，在其二元重点坚持。 总的来说，本研究的结果将促进适应性和非适应性二元的识别 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患者及其家庭护理人员的依从性，以及 从而改善患者的健康结果。

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.