EHealth Mindful Movement and Breathing to Improve Gynecologic Cancer Surgery Outcomes

EHealth 正念运动和呼吸可改善妇科癌症手术结果

• 批准号: 9369364
• 负责人: Stephanie Jean Sohl
• 金额: $ 15.5万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9369364
• 关键词: Abdomen; Acute; Acute Pain; Address; Adherence; Adopted; Adult; Affect; Affective; Aftercare; Analgesics; Breathing; Breathing Exercises; Cancer Patient; Cancer Survivor; Chronic; Clinical Informatics; Combined Modality Therapy; Control Groups; Data; Deep Vein Thrombosis; Diagnosis; Dimensions; Distress; Elements; Eligibility Determination; Enrollment; Face; Feasibility Studies; Future; Goals; Guidelines; Health Personnel; Hospitalization; Hypnosis; Ileus; Integrative Medicine; Intervention; Investigation; Length of Stay; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Manuals; Meditation; Methodological Studies; Methods; Mind-Body Intervention; Movement; Operative Surgical Procedures; Outcome; Pain; Pain management; Participant; Patients; Perioperative; Persons; Pharmacology; Phase; Physiological; Population; Populations at Risk; Postoperative Pain; Postoperative Period; Prevalence; Procedures; Public Health; Quality of life; Randomized Clinical Trials; Randomized Controlled Trials; Recovery; Recruitment Activity; Relaxation; Reporting; Research; Schedule; Sensory; Sleep disturbances; Subgroup; Surgical complication; Symptoms; Testing; Time; Travel; Woman; Work; Wound Healing; Yoga; associated symptom; attentional control; body-mind; cancer surgery; chronic pain; cost; eHealth; effective intervention; efficacy trial; experience; field study; improved; innovation; malignant breast neoplasm; mindfulness; multimodality; non-opioid analgesic; operation; preference; prevent; psychologic; psychological distress; retention rate; symptom management; treatment as usual

PROJECT SUMMARY Improved management of acute perioperative pain and co-morbid symptoms (i.e., sleep disturbances, psychological distress) among women undergoing surgery for suspected gynecologic malignancies may proactively reach an at-risk population and reduce the overall burden of chronic pain. In fact, patients who are women, have surgery, and are diagnosed with cancer are among the subgroups most vulnerable to chronic pain. Mind-body interventions are commonly sought after nonpharmacological approaches for pain and other symptom management, particularly in cancer patients. Yoga is a multimodal mind-body intervention that may optimally address pain and co-morbid symptoms through psychological and physiological mechanisms not affected by pain medication. Yoga has a potential advantage over other nonpharmacological interventions because of its multiple components that also support the usual care goals of encouraging mobility and deep breathing and thus may improve additional surgical complications (e.g., ileus, deep venous thrombosis). The proposed Mindful Movement and Breathing (MMB) brief yoga intervention is innovative because it adapts key elements of a longer intervention to a short-term format that can be implemented during the acute perioperative timeframe. The proposed research will adapt the already developed in-person MMB intervention and in-person attention control (AC) to an eHealth format (Aim I). Aim II will field test implementation strategies for the resulting eMMB, and Aim III will determine feasibility and acceptability of the eMMB and AC to reduce pain and other surgical outcomes through an exploratory randomized clinical trial among women undergoing surgery for suspected gynecologic malignancies. Developing and assessing the feasibility of an AC group in an eHealth intervention will be instrumental for the next stages of the proposed research and may be applicable to the study of mind-body interventions more broadly. Following this feasibility study, we will conduct a fully- powered investigation of the efficacy of the optimized eMMB for reducing pain, sleep disturbance, and psychological distress after gynecologic cancer surgery. The brevity and accessibility of the intervention, and the increasing popularity of yoga, make the eMMB a strong candidate for future dissemination. If we demonstrate efficacy of the eMMB for improving surgical outcomes of women who undergo surgery for a suspected gynecologic malignancy, results may be generalizable to other perioperative patients and have important public health implications for reducing the growing population affected by chronic pain. The proposed research addresses priorities outlined by the National Center for Complementary and Integrative Health (i.e., investigates a mind-body approach for symptom management).

项目摘要 改善急性围手术期疼痛和合并症状的治疗（即睡眠障碍， 心理困扰）在接受可疑的妇科恶性肿瘤手术的妇女中 积极地达到高危人群，并减轻慢性疼痛的总体负担。实际上，患者是 妇女，接受手术，被诊断出患有癌症，是最容易受到慢性病的亚组 疼痛。通常寻求思维体干预措施，用于疼痛和其他的非药理学方法 症状管理，特别是在癌症患者中。瑜伽是一种多模式的心身干预，可能 通过心理和生理机制最佳地解决疼痛和合并症状 受止痛药的影响。瑜伽比其他非药理学干预措施具有潜在的优势 由于其多个组件也支持鼓励流动性和深度的通常护理目标 呼吸，因此可能会改善其他手术并发症（例如，肠胃，深静脉血栓形成）。这 提议的正念运动和呼吸（MMB）简短的瑜伽干预具有创新性，因为它适应了密钥 较长的干预措施到急性期间可以实施的短期格式的元素 围手术期限。拟议的研究将适应已经开发的面对面的MMB干预 和面对面的注意力控制（AC）到eHealth格式（AIM I）。 AIM II将现场测试实施策略 对于由此产生的EMMB，AIM III将确定EMMB和AC的可行性和可接受性 通过接受探索性的随机临床试验，疼痛和其他手术结局 可疑的妇科恶性肿瘤的手术。开发和评估AC组在 eHealth干预措施将在拟议研究的下一个阶段发挥作用，可能适用于 心身干预的研究更广泛。经过这项可行性研究，我们将进行一次 优化EMMB对减轻疼痛，睡眠障碍和 妇科癌症手术后的心理困扰。干预的简短和可及性，以及 瑜伽的日益普及，使EMMB成为未来传播的有力候选人。如果我们 展示了EMMB对改善接受手术的女性手术结局的功效 可疑的妇科恶性肿瘤，结果可能是其他围手术期患者的推广性的，并且具有 减少受慢性疼痛影响的人群不断增长的人群的重要意义。提议 研究介绍了国家互补与综合健康中心概述的优先事项（即 调查了症状管理的思维方式方法）。