Psychoeducation for Spouses of Women with Breast Cancer

描述(由申请人提供)：2007年，估计有178,480名女性新诊断为非转移性乳腺癌，另有62,030人将被诊断为原位[导管或小叶]疾病(美国癌症学会，2007)。虽然乳腺癌是一种乳房疾病，但它对配偶和确诊患者都有影响。横断面和纵向研究都记录了癌症导致的严重焦虑、抑郁情绪、婚姻紧张和婚姻沟通困难。尽管这些问题的规模很大，影响的人数也很多，但帮助夫妇的干预研究远远落后于描述性研究。目的：这项研究的目的是测试为期5个疗程的全程心理教育干预的有效性，即帮助她治疗计划，以及它对这对夫妇适应最近诊断的非转移性乳腺癌的影响。该干预来源于两个理论，即乳腺癌适应的关系模型和班杜拉的社会认知理论。设计/方法：总共288对夫妇将从太平洋西北部的多个提供者地点招募，并随机分为试验组或替代治疗对照组[标准护理]。试验组的配偶将接受5个1小时的面对面教育，由受过专门培训的患者教育者授课。居家作业将涉及配偶和确诊的妻子。控制组的配偶将收到一次性邮寄的宣传册，该宣传册可在公共领域获得，重点是支持确诊患有乳腺癌的妻子。妻子和配偶都将在基线、立即退出干预时以及标准化适应措施(焦虑、抑郁情绪、行为管理技能、管理自信心、婚姻适应、婚姻沟通和配偶对妻子的支持)的3个月和6个月的随访时进行测量。采用重复测量ANCOVA方法评价干预效果。公共卫生相关性：尽管每年有近20万女性及其配偶受到乳腺癌的影响，但帮助她们管理癌症对她们生活和婚姻调整的影响的计划一直非常缺乏。拟议的干预措施提供了一个可持续的教育计划，具有很高的潜力，可以很容易地转移到现实生活中的提供者环境。

DESCRIPTION (provided by applicant): In 2007, an estimated 178, 480 women were newly diagnosed with non-metastatic breast cancer and an additional 62,030 will be diagnosed with in situ [ductal or lobular] disease (ACS, 2007). Although breast cancer is a disease of the breast, it is an illness that impacts both the spouse and the diagnosed patient. Both cross sectional and longitudinal studies have documented the presence of substantial anxiety, depressed mood, tension in the marriage, and marital communication difficulties that are attributed to the cancer. Despite the magnitude of these issues and the large numbers affected, intervention research to help couples has lagged far behind descriptive research. Aims: The purpose of this study is to test the efficacy of a 5-session, fully manualized psychoeducational intervention, the Helping Her Heal Program, and its impact on the couple's adjustment to recently diagnosed non-metastatic breast cancer. The intervention derives from 2 theories, the Relational Model of Adjustment to Breast Cancer and Bandura's Social Cognitive Theory. Design/Methods: A total of 288 couples will be recruited from multiple provider sites in the Pacific Northwest and randomized into either the experimental or alternative treatment control group [standard care]. Spouses in the experimental group will receive 5, 1-hour face-to-face delivered educational sessions from a specially trained patient educator. At-home assignments will involve both the spouse and diagnosed wife. Spouses in the control group will receive a 1-time mailing of a brochure available in the public domain that focuses on supporting a diagnosed wife with breast cancer. Both wives and spouses will be measured at baseline, at immediate exit from the intervention, and at 3- and 6-months follow-up on standardized measures of adjustment (anxiety, depressed mood, behavioral management skills, self-confidence to manage, marital adjustment, marital communication, and spouses' support to the wife). Repeated measures ANCOVA will be used to evaluate intervention efficacy. PUBLIC HEALTH RELEVANCE: Despite the almost 200,000 women and their spouses who are affected annually by breast cancer, programs to assist them manage the impact of the cancer on their lives and marital adjustment have been sorely lacking. The proposed intervention offers a sustainable educational program with high potential for easy transfer to real life provider settings.