Sexual Distress and Body Image Distress in Younger Breast Cancer Survivors

描述(申请人提供)：这项研究的目的是检查MBSR对年轻乳腺癌幸存者的性苦恼和身体形象相关苦恼症状的影响。在年轻的乳腺癌幸存者中，与性有关的问题很普遍，据报道，在手术和辅助治疗后，这一人群中会出现性困扰和身体形象问题。该项目将建立在针对乳腺癌幸存者的MBSR症状群试验1R01CA131080的资源和优势的基础上，该试验由这项NRSA应用的发起人Lengacher博士进行，并将补充Lengacher博士的研究目标。对于这项博士前NRSA，将在这一年轻的临床人群中获得更多的证据，他们是赞助商的R01研究的对象，以确定：(1)治疗后处于过渡阶段的年轻乳腺癌女性的心理和身体痛苦水平；(2)作为一种减压计划的基于正念的压力减轻-乳腺癌(MBSR(BC))在多大程度上有效地改善与性有关的痛苦，即性痛苦和与身体形象相关的痛苦；以及(3)与年长的乳腺癌幸存者相比，这部分年轻患者是否从MBSR(BC)中获得了最大的好处。由于性苦恼和与身体形象相关的苦恼影响了这一人群的生活质量，因此，对于性苦恼和身体形象苦恼的程度了解有限，将采取两个阶段的研究方法。首先，在第一阶段，将对参与R01研究的21-54岁年轻乳腺癌幸存者的基线数据进行二次数据分析。第一阶段的具体目标是通过对R01研究乳腺癌幸存者MBSR症状群试验收集的数据进行二次分析，评估年轻女性的痛苦水平，包括抑郁、焦虑、对复发的恐惧、心理和身体痛苦以及生活质量。对于第二阶段，一项先导性研究，也是论文研究的重点，将在赞助商R01拨款中的80名乳腺癌幸存者中实施。这项初步研究的目的将是1)评估MBSR(BC)计划在改善与性困扰和身体形象相关的痛苦以及心理、身体症状和生活质量方面的有效性，以及2)评估MBSR(BC)计划取得的积极效果是否被基线测量的特定患者特征所修正。由此产生的数据将提供对性痛苦和与身体形象相关的痛苦的更好的了解，为未来的疾病预防和改善因乳腺癌治疗而经历与性痛苦和身体形象相关的痛苦的妇女的生活质量提供基础。预计这项研究的结果将进一步发展或调整适合于改善该人群中妇女的症状管理、支持和教育的具体干预措施。

DESCRIPTION (provided by applicant): The purpose of this research is to examine the impact of MBSR on the symptoms of sexual distress and body image related distress in younger breast cancer survivors. Problems related to sexuality in younger breast cancer survivors are prevalent and often reported following surgical and adjuvant treatment leading to sexual distress and body image issues in this population. This project will build upon the resources and strengths of the MBSR Symptom Cluster Trial for Breast Cancer Survivors, 1R01CA131080, which is being conducted by Dr. Lengacher, the sponsor of this NRSA application, and will complement the goals of Dr. Lengacher's study. For this Pre-doctoral NRSA, additional evidence in this younger clinical population who are subjects in the Sponsor's R01 study will be obtained to determine: (1) levels of psychological and physical distress in younger women with breast cancer in transition after treatment; (2) the extent to which the Mindfulness-Based Stress Reduction-Breast Cancer (MBSR (BC)) as a stress reducing program is efficacious in improving distress related to sexuality, i.e. sexual distress and body image related distress; and (3) if this subgrou of younger patients derive the most benefit from MBSR (BC) compared to older breast cancer survivors. To contribute to the limited knowledge regarding the extent of sexual distress and body image related distress as they impact the quality of life in this population, a two-phase study approach will be taken. First, in Phase 1, a secondary data analysis will be performed on baseline data of the younger breast cancer survivors, age 21-54 participating in the R01 study. The specific aim for Phase 1 is to assess the levels of distress among young women including depression, anxiety, fear of recurrence, psychological and physical distress, and quality of life through secondary analysis of data collected in the R01 study MBSR Symptom Cluster Trial for Breast Cancer Survivors. For Phase 2,a pilot study, also the focus of the dissertation research, will be implemented among a subgroup of 80 breast cancer survivors from the Sponsor's R01 grant. The aims for this pilot study will be to 1) evaluate the efficacy of the MBSR (BC) program in improving sexual distress and body image related distress along with psychological, physical symptoms and quality of life and 2) evaluate whether positive effects achieved from the MBSR (BC) program are modified by specific patient characteristics measured at baseline. Resulting data will provide a better understanding of sexual distress and body image related distress, providing a foundation for future disease prevention and improved quality of life in women experiencing sexual distress and body image related distress as a result of their breast cancer treatment. It is anticipated that the findings of this study will provide further development or adaptation of specific interventions appropriate for improved symptom management, support, and education for women in this population