Phone-Based Intimacy Enhancement Intervention for Couples facing Breast Cancer

针对乳腺癌夫妇的基于电话的亲密关系增强干预措施

• 批准号: 8811654
• 负责人: Jennifer Barsky Reese
• 金额: $ 15.23万
• 依托单位: RESEARCH INST OF FOX CHASE CAN CTR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-01 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8811654
• 关键词: Address; Aftercare; Area; Body Image; Breast; Breast Cancer Patient; Breast Cancer Treatment; Breast Cancer survivor; Caring; Cognitive; Communication; Counseling; Couples; Development; Diagnosis; Dimensions; Distress; Dryness; Emotional; Ensure; Esthesia; Focus Groups; Fostering; Future; Goals; Guidelines; Health; Impairment; Intervention; Intervention Studies; Interview; Investigation; Lead; Left; Long-Term Survivors; Malignant Neoplasms; Measures; Mental Health; Morbidity - disease rate; Outcome; Pain; Patient Care; Patients; Personal Satisfaction; Persons; Pilot Projects; Population; Professional counselor; Protocols documentation; Public Health; Quality of life; Randomized; Recommendation; Research; Risk Factors; Sex Functioning; Sexual Partners; Source; Structure; Surveys; Telephone; Testing; Time; Translating; Vagina; Woman; Work; Writing; base; breast surgery; chemotherapy; clinical care; colon cancer patients; control trial; coping; experience; health related quality of life; help-seeking behavior; hormone therapy; improved; innovation; interest; intervention effect; intimate behavior; malignant breast neoplasm; meetings; neglect; novel; peer; pilot trial; preference; programs; psychological distress; psychosocial; public health relevance; satisfaction; therapy design; volunteer; web site; willingness

 DESCRIPTION (provided by applicant): The majority of women diagnosed and treated for breast cancer survive 5 years past diagnosis, making quality of life (QOL) concerns highly salient. Sexual concerns are common and distressing for many women with breast cancer and serve as a major source of QOL impairment. Unlike other aspects of QOL that improve over time after breast cancer treatment, sexual concerns often persist and do not typically resolve without intervention. Yet these concerns are typically neglected in patients' care, leaving them underdiagnosed and undertreated. Addressing breast cancer survivors' sexual concerns can reduce distress, support their intimate relationships, and foster effective adjustment. However, existing sexual QOL interventions that address the sexual concerns of breast cancer survivors suffer from limitations in both content and format. For instance, existing sexual QOL interventions do not include current management recommendations and are not generally in a format that can be widely disseminated. A telephone-based format is a viable, effective alternative to in- person counseling that would enhance the potential for dissemination and be ideal for reaching long-term survivors. Previously, the PI demonstrated that demonstrated that a 4-session telephone-based Intimacy Enhancement (IE) intervention improved intimacy and sexual outcomes for colorectal cancer patients and their partners. This intervention holds promise for addressing the concerns of breast cancer survivors, but additional work is needed to tailor this intervention to breast cancer survivors because these populations differ in their experiences of sexual concerns, in the risk factors for worse sexual morbidity, and in appropriate management approaches. The central goal of the proposed research is to tailor the telephone-based IE intervention to breast cancer survivors and conduct a preliminary test of the intervention in a controlled trial. First, qualitative focus groups will identify patient preferencs for content and structure which will be used to tailor the intervention to the needs of this population subsequent cognitive interviews will ensure comprehensibility. Second, the pilot trial will examine the feasibility, acceptability, and preliminary efficacy on patient and partner sexual QOL and relationship outcomes, and on patient psychosocial outcomes (e.g., body image distress). Finally, based on the rationale that barriers exist that limit participation in intensiv sexual QOL interventions for breast cancer survivors, an innovative developmental aim will investigate the perspectives of study-eligible patient candidates who opt out of participating in the pilot trial. This developmental investigation will identify the participation barriers and intervention preferences of breast cancer survivors with sexual concerns who opt out of the intensive trial in order to inform the development of different interventions for future study. Ultimately, this program of research will lead to the availability of a range of interventions well equipped to address the undertreated area of sexual QOL for those with breast and potentially other cancers.

 描述（由申请人提供）：大多数诊断和治疗乳腺癌的女性在诊断后存活5年，使生活质量（QOL）问题非常突出。对于许多乳腺癌女性来说，性问题是常见和令人痛苦的，并且是QOL受损的主要来源。与乳腺癌治疗后随着时间的推移而改善的生活质量的其他方面不同，性问题通常持续存在，并且通常不会在没有干预的情况下解决。然而，这些问题在病人的护理中通常被忽视，使他们诊断不足，治疗不足。解决乳腺癌幸存者的性问题可以减少痛苦，支持他们的亲密关系，并促进有效的调整。然而，现有的性生活质量干预措施，解决乳腺癌幸存者的性问题遭受的限制，在内容和形式。例如，现有的性生活质量干预措施不包括当前的管理建议，并且通常不是可以广泛传播的格式。基于电话的形式是一个可行的，有效的替代面对面的咨询，将提高传播的潜力，是理想的接触长期幸存者。此前，PI证明了4次基于电话的亲密关系增强（IE）干预改善了结直肠癌患者及其伴侣的亲密关系和性结局。这种干预措施有望解决乳腺癌幸存者的问题，但需要做更多的工作，使这种干预措施适合乳腺癌幸存者，因为这些人群在性问题的经验，在更糟糕的性发病率的风险因素和适当的管理方法方面有所不同。拟议研究的中心目标是为乳腺癌幸存者量身定制基于电话的IE干预，并在对照试验中进行干预的初步测试。首先，定性焦点小组将确定患者对内容和结构的偏好，这将用于根据该人群的需求定制干预措施，随后的认知访谈将确保可理解性。其次，试点试验将检查患者和伴侣性生活质量和关系结果以及患者心理社会结果（例如，身体形象困扰）。最后，基于存在限制乳腺癌幸存者参与强化性生活质量干预的障碍的理由，创新的发展目标将调查选择退出试点试验的符合研究条件的患者候选人的观点。这项发展调查将确定有性问题的乳腺癌幸存者选择退出强化试验的参与障碍和干预偏好，以便为未来研究提供不同干预措施的发展信息。最终，这项研究计划将导致一系列干预措施的可用性， 为乳腺癌和其他潜在癌症患者提供治疗不足的性生活质量领域。