Individualized Dual Process Intervention for Bereaved Partners after Cancer Death

向患有晚期癌症的伴侣提供临终关怀的个人通常开始丧亲之痛 有额外压力源的过程。我们知道，这些伙伴的丧亲之痛可能是长期的 并影响他们生活的方方面面，但我们对理论上的有效性知之甚少。 干预措施，以提高他们的应对能力和成果。这个项目是独一无二的，因为我们：1）测试 基于双过程模型的一种新的有希望的干预方法的有效性，2）使用 可与来自另一个组织的组交付形式进行比较的个体定制干预形式 研究，3）使用50岁以上的配偶/伴侣样本，他们使用临终关怀家庭服务进行癌症相关治疗， 死亡，4）是P01应用程序中3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 管理人员对参与者的死亡前和死亡后的应对过程和结果。该研究表明， 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。 损失取向是指对损失的心理情感方面的管理， 学习日常生活的新技能。主要目的是测试一个L-Risk的有效性 干预单独提供给80个临终关怀合作伙伴从癌症相关的死亡相比， 80个类似的丧亲者在非治疗的常规护理条件下。受试者将被随机分配至 另外两个POI项目中的2个研究条件。应对和结果测量是 在基线（丧亲2个月）和14周干预后立即以及8和14周时获得 数月丧亲那些处于l-型糖尿病状态的人预计在应对方面会有更大的改善， 在我们的另一项研究中，相互依存的目标 解决临终前照顾者应对、痛苦和RN-照顾者沟通之间的关系， 死后丧亲的结果。主要的分析方法是潜在增长曲线分析， 通过多层次解释模型和其他标准参数技术增强。

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.