Training providers in CBT plus Hypnosis - an evidence-based fatigue intervention

CBT 加催眠培训提供者 - 一种基于证据的疲劳干预措施

• 批准号: 8997819
• 负责人: Guy H Montgomery
• 金额: $ 30.45万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-23 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8997819
• 关键词: Address; Adjuvant Radiotherapy; Adverse effects; Age; American; American Society of Clinical Oncology; Behavioral; Biological; Breast Cancer Patient; Cancer Education Grant Program; Cancer Patient; Cancer Survivor; Caring; Characteristics; Clinical; Cognitive; Cognitive Therapy; Control Groups; Country; Data; Diagnosis; Disease-Free Survival; E-learning; Education; Educational process of instructing; Educational workshop; Effectiveness; Empathy; Ensure; Evaluation; Expectancy; Faculty; Fatigue; Feedback; Film; Future; Goals; Guidelines; Healthcare; Healthy People 2020; Hypnosis; Intervention; Knowledge; Learning; Licensing; Life; Life Expectancy; Link; Literature; Malignant Neoplasms; Medical; Methods; Mission; Modality; Modeling; Multimedia; National Comprehensive Cancer Network; Nurses; Outcome; Participant; Patients; Play; Professional Organizations; Program Evaluation; Programmed Learning; Provider; Psychiatrist; Psychologist; Psychosocial Assessment and Care; Public Health; Publishing; Quality of Care; Quality of life; Radiation therapy; Randomized Controlled Trials; Recruitment Activity; Reporting; Resources; Role; Site; Social Workers; Supportive care; Symptoms; System; Testing; Therapeutic; Time; Training; Training Programs; Translations; Woman; adverse outcome; advocacy organizations; base; cancer care; cancer radiation therapy; clinical practice; cohort; evidence base; experience; falls; fight against; improved; lectures; malignant breast neoplasm; prevent; psychosocial; public health relevance; research study; research to practice; response; satisfaction; skills; success; survivorship; symposium; theories; uptake; weapons

 DESCRIPTION (provided by applicant): In 2014, over 230,000 American women were diagnosed with breast cancer (BCa), and nearly half will undergo adjuvant radiotherapy (RT). Although BCa RT increases disease-free survival and life expectancy, it is not without side-effects, primarily fatigue. Fatigue is the most prevalent symptom during BCa RT and it continues for months afterwards, having pervasive and detrimental effects on numerous aspects of patients' functioning and quality of life. Fatigue management, specifically cognitive-behavioral approaches, is recommended by the National Comprehensive Cancer Network and the American Society of Clinical Oncology. To address the important clinical and public health implications of BCa RT-related fatigue, our group developed and tested a brief Cognitive-Behavioral Therapy (CBT) intervention incorporating Hypnosis (CBTH) in two randomized controlled trials. Results revealed that CBTH managed RT-related fatigue in BCa patients during RT and for up to six months afterwards. Objectives: The goal of the proposed R25E is to train psychosocial cancer care providers in CBTH, giving them a new weapon in their fight against BCa RT-related fatigue. The Specific Aims are to: 1) Develop and implement a blended training program to teach psychosocial cancer care providers how to deliver CBTH to manage RT-related fatigue in BCa patients; 2) Evaluate the effectiveness of a CBTH training program on psychosocial cancer care providers' CBTH knowledge, skills, and "real world" clinical practice; and, 3) Identify trainee characteristics which predict CBTH knowledge, skills, and "real world" practice. The CBTH training content is guided by Roth & Philing's CBT competency model. Training will focus on the following competency domains: 1) CBTH theory and guiding principles; 2) Practical CBTH competencies (e.g., how to conduct CBT and Hypnosis); 3) Clinical and biological aspects of RT-related fatigue; 4) CBTH for fatigue in BCa RT patients; and, 5) Metacompetencies (e.g., therapeutic alliance, expectancies, empathy, cultural factors). The evaluation plan for the CBTH training program is guided by Miller's pyramid of clinical competencies, and will focus on three levels of evaluation: Knowledge and Practical Understanding, Skills, and Clinical Practice. Methods: Licensed psychosocial cancer care providers (N=400; including nurses, social workers, psychologists, and psychiatrists) from across the country will be recruited via professional organizations, listservs, and conferences. Trainees will participate in a blended training program including multimedia E-Learning and a 3-day live workshop, with evaluations linked to each modality. Trainees will also be evaluated at 3 and 6 months following the workshop. The training program will be disseminated through advocacy and professional organizations. Long-term goals: The proposed R25E is a critical first step toward improving quality of care and quality of life for BCa patients undergoing RT by producing a large cohort of psychosocial cancer care providers who are CBTH competent. Connection to NCI mission: This project is consistent with the Healthy People 2020 goal of improving quality of life of cancer patients and survivors.

 描述（申请人提供）：2014年，超过23万名美国女性被诊断患有乳腺癌（BCa），其中近一半将接受辅助放射治疗（RT）。尽管 BCa RT 可以提高无病生存率和预期寿命，但它并非没有副作用，主要是疲劳。疲劳是 BCa RT 期间最常见的症状，并会在术后持续数月，对患者功能和生活质量的许多方面产生普遍的有害影响。国家综合癌症网络和美国临床肿瘤学会推荐疲劳管理，特别是认知行为方法。为了解决 BCa RT 相关疲劳的重要临床和公共卫生影响，我们的小组在两项随机对照试验中开发并测试了一种结合催眠 (CBTH) 的简短认知行为疗法 (CBT) 干预措施。结果显示，CBTH 在放疗期间以及放疗后长达 6 个月的时间内管理了 BCa 患者与放疗相关的疲劳。目标：拟议的 R25E 的目标是培训 CBTH 的社会心理癌症护理人员，为他们提供对抗 BCa RT 相关疲劳的新武器。具体目标是： 1) 制定并实施混合培训计划，教导社会心理癌症护理提供者如何提供 CBTH 来管理 BCa 患者与放疗相关的疲劳； 2) 评估 CBTH 培训计划对社会心理癌症护理提供者的 CBTH 知识、技能和“现实世界”临床实践的有效性； 3) 确定可预测 CBTH 知识、技能和“现实世界”实践的学员特征。 CBTH 培训内容以 Roth & Philing 的 CBT 能力模型为指导。培训将重点关注以下能力领域： 1） CBTH 理论和指导原则； 2）实用的CBTH能力（例如如何进行CBT和催眠）； 3) 放疗相关疲劳的临床和生物学方面； 4) CBTH 治疗 BCa RT 患者疲劳； 5) 元能力（例如治疗联盟、期望、同理心、文化因素）。 CBTH培训项目的评估计划以米勒临床能力金字塔为指导，将重点评估三个层面：知识和实践理解、技能和临床实践。方法：将通过专业组织、列表服务和会议招募来自全国各地的有执照的社会心理癌症护理提供者（N = 400；包括护士、社会工作者、心理学家和精神科医生）。学员将参加混合培训计划，包括多媒体电子学习和为期 3 天的现场研讨会，并对每种模式进行评估。学员还将在研讨会结束后 3 个月和 6 个月接受评估。培训计划将通过宣传和专业组织进行传播。长期目标：拟议的 R25E 是通过培养一大批具有 CBTH 能力的心理社会癌症护理提供者来提高接受 RT 的 BCa 患者的护理质量和生活质量的关键的第一步。与 NCI 使命的联系：该项目与“健康人民 2020”改善癌症患者和幸存者生活质量的目标一致。