Psychoeducation for Spouses of Women with Breast Cancer

描述（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名将被诊断为原位[导管或小叶]疾病（ACS，2007）。虽然乳腺癌是一种乳腺疾病，但它是一种影响配偶和确诊患者的疾病。横截面和纵向研究都记录了大量的焦虑，抑郁情绪，婚姻紧张，婚姻沟通困难，这是由于癌症的存在。尽管这些问题的严重性和大量的影响，干预研究，以帮助夫妇已经远远落后于描述性研究。目的：本研究的目的是测试一个5个疗程的，完全手动化的心理教育干预，帮助她治愈计划的疗效，及其对夫妇的调整，最近诊断的非转移性乳腺癌的影响。干预理论来源于两个理论，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：将从太平洋西北部的多个提供者地点招募共288对夫妇，并随机分配到实验组或替代治疗对照组[标准治疗]。实验组的配偶将接受由经过专门培训的患者教育者提供的5个1小时的面对面教育课程。家庭任务将涉及配偶和确诊的妻子。对照组的配偶将收到一份一次性邮寄的公共领域的小册子，重点是支持诊断为乳腺癌的妻子。妻子和配偶都将在基线、立即退出干预以及3个月和6个月随访时进行标准化调整措施（焦虑、抑郁情绪、行为管理技能、管理自信、婚姻调整、婚姻沟通和配偶对妻子的支持）的测量。重复测量ANCOVA将用于评估干预疗效。公共卫生相关性：尽管每年有近20万名妇女及其配偶受到乳腺癌的影响，但帮助她们管理癌症对生活和婚姻调整影响的计划却非常缺乏。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，易于转移到真实的生活提供者的设置。

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.