Cancer treatment retraumatization in sexual abuse survivors

性虐待幸存者的癌症治疗再创伤

• 批准号: 8635083
• 负责人: Julie B. Schnur
• 金额: $ 18.43万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-18 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8635083
• 关键词: Adult; Advanced Malignant Neoplasm; Age; Anus; Appointment; Behavioral; Body part; Breast; Cancer Control Research; Cancer Patient; Cancer Survivor; Characteristics; Child Abuse; Child Sexual Abuse; Cognitive; Colonoscopy; Colorectal; Communities; Development; Diagnosis; Dissociation; Event; Exhibits; Exposure to; Feeling; Female; Foundations; Fright; Future; Gel; Gender; Genital system; Goals; Health Personnel; Healthcare; Healthy People 2020; Individual; Internet; Intervention; Knowledge; Latex; Life; Literature; Lubricants; Malignant Neoplasms; Mechanics; Medical; Memory; Methodology; Minor; Mission; Modeling; Nature; Nursing Research; Oral; Outcome Study; Pain; Participant; Patient Care; Patients; Penetration; Population; Procedures; Public Health; Quality of Care; Quality of life; Reaction; Recruitment Activity; Research; Risk; Scientific Advances and Accomplishments; Seminal fluid; Severities; Sexual abuse; Shame; Site; Surveys; Survival Rate; Survivors; Testing; Theoretical model; Touch sensation; Ultrasonography; Underserved Population; United States National Institutes of Health; Vulnerable Populations; Woman; cancer care; cancer prevention; cancer therapy; condoms; experience; improved; innovation; male; member; men; programs; public health relevance; response; statistics; survivorship; therapy development; tool; web site

DESCRIPTION (provided by applicant): The statistics on sexual abuse (SA) are staggering: 1 in 4 women and 1 in 6 men have experienced abusive sexual experiences before the age of 18. Healthcare procedures, even those that may seem minor or routine, share similarities with childhood sexual abuse (e.g., insertion of objects into the body, exposure, vulnerability, pain, powerlessness). Due to these similarities, SA survivors can feel retraumatized by healthcare procedures. Not surprisingly, to avoid this retraumatization, SA survivors may avoid healthcare (e.g., delay or cancel treatment). Despite the often invasive/intimate medical procedures involved in cancer treatment, and the serious consequences of cancer treatment avoidance, there has been no empirical study to date of the relationship between cancer treatment retraumatization and cancer treatment avoidance in sexually abused cancer (SACA) patients. Objectives: The overall goal of the project is to develop a greater understanding of SACA patients experiences of cancer treatment, how this suffering relates to treatment avoidance, and which SACA patients are most at risk for cancer treatment retraumatization and avoidance. Specific Aims are to: 1) test the hypothesis that increased cancer treatment retraumatization will be associated with increased cancer treatment avoidance in SACA individuals; 2) test the hypotheses that increased cancer treatment retraumatization and avoidance will be associated with: a) SA severity (e.g., duration, force), b) exposure to other types of childhood abuse, and c) exposure to pre-cancer traumatic life events; and, 3) explore the influence of gender and cancer characteristics on study outcomes. Methodology: The study is guided by the Healthcare Retraumatization Avoidance (HRA) model. Aims 1-3 will be accomplished through an online survey administered to 600 SACA patients (300 men, 300 women) recruited from SA survivor support websites, a cancer support website, and a crowdsourcing website (Amazon Mechanical Turk). The online approach will improve patient experience by providing anonymity, and will improve the generalizability of the project by allowing for nationwide recruitment. Path analysis will be used for study analyses. Long-term goals: The proposed study is a critical first step toward improving quality of care and quality of life of SACA patients undergoing cancer treatment. The project will advance scientific knowledge and will aid the cancer care community in understanding the difficulties SACA patients experience during cancer treatment. Results will serve as a foundation for a program of research including the development of interventions and assessment tools to reduce cancer treatment retraumatization and avoidance in this vulnerable population. Connection to NIH/NCI mission: This project is consistent with the Healthy People 2020 goal of improving quality of life of cancer patients and survivors.

性虐待（SA）的统计数据是惊人的：四分之一的女性和六分之一的男性在18岁之前经历过虐待性经历。医疗程序，即使是那些看起来很小或很常规的程序，也与儿童性虐待有相似之处（例如，将物体插入身体、暴露、脆弱、疼痛、无力感）。由于这些相似之处，SA幸存者可能会因医疗程序而感到再次创伤。毫不奇怪，为了避免这种再创伤，SA幸存者可能会避免医疗保健（例如，延迟或取消治疗）。尽管癌症治疗中涉及的侵入性/亲密的医疗程序，以及避免癌症治疗的严重后果，迄今为止，还没有实证研究性虐待癌症（SACA）患者的癌症治疗再创伤和癌症治疗避免之间的关系。目的：该项目的总体目标是更好地了解SACA患者的癌症治疗经历，这种痛苦与避免治疗的关系，以及哪些SACA患者最有可能遭受癌症治疗的再创伤和避免。具体目标是：1）检验SACA个体中增加的癌症治疗再创伤将与增加的癌症治疗回避相关的假设; 2）检验增加的癌症治疗再创伤和回避将与以下相关的假设：持续时间、暴力），B）遭受其他类型的儿童虐待，以及c） 暴露于癌前创伤性生活事件; 3）探讨性别和癌症特征对研究结果的影响。方法：本研究是由医疗再创伤避免（HRA）模型的指导。目标1-3将通过对600名SACA患者（300名男性，300名女性）进行在线调查来实现，这些患者是从SA幸存者支持网站、癌症支持网站和众包网站（亚马逊土耳其机器人）招募的。在线方法将通过提供匿名来改善患者体验，并将通过允许在全国范围内招募来提高项目的普遍性。研究分析将使用路径分析。长期目标：这项拟议的研究是提高接受癌症治疗的SACA患者的护理质量和生活质量的关键的第一步。该项目将推进科学知识，并将帮助癌症护理社区了解SACA患者在癌症治疗期间遇到的困难。研究结果将作为一项研究计划的基础，包括开发干预措施和评估工具，以减少癌症治疗、再创伤和避免这一弱势群体的发生。与NIH/NCI使命的联系：该项目符合2020年健康人的目标，即改善癌症患者和幸存者的生活质量。