Individualized Dual Process Intervention for Bereaved Partners after Cancer Death

为患有晚期癌症的伴侣提供临终关怀的个人往往开始丧失亲人 处理额外的压力源。我们知道，这些伙伴的丧亲之痛可能是长期的。 几乎影响到他们生活的方方面面，但我们对理论上的 采取干预措施，提高他们的应对能力和结果。这个项目是独特的，因为我们：1)测试 基于双过程模型(DPM)的一种新的有前途的干预方法的有效性，2)使用 个人定制的干预格式，可与来自另一家公司的团体提供的格式进行比较 研究，3)使用50岁的配偶/伴侣样本，他们使用临终关怀家庭服务来治疗癌症相关疾病 死亡，4)是P01应用程序中三个相互依赖的项目之一，该应用程序检查从 临终关怀对长期丧亲适应的影响及临终关怀RN病例的研究 管理人员对参与者死前和死后的应对过程和结果进行了评估。DPM认为 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。 失落取向指的是对失落的心理情绪方面的管理，以及恢复取向 学习新的日常生活技能。主要目标与测试L-DPM的有效性有关 分别向80名因癌症死亡而丧命的临终关怀合作伙伴提供干预服务 80名相似的失去亲人的人，处于未接受治疗的普通护理条件下。参赛者将被随机分为 2学习其他两个POL项目中的条件。应对和结果措施是 在基线(丧失亲人2个月)和干预14周后立即以及在8和14周获得 几个月前就失去了亲人。处于L-DPM状态的患者预计在应对和应对方面有更大的改善 在我们的另一项研究中，结果比对照组或DPM治疗组的结果要好。相互依存的目标 阐述生前照顾者应对、痛苦和RN-照顾者沟通之间的关系，以及 死亡后丧失亲人的后果。主要的统计方法将是潜在增长曲线分析， 增加了多层次解释模型和其他标准参数技术。

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.