Addressing Psychological Risk Factors Underlying Smoking Persistence in COPD Patients

项目摘要/摘要 慢性阻塞性肺疾病(COPD)主要由吸烟和吸烟引起 戒烟是减缓疾病进展的一线治疗方法。尽管如此，近50%的COPD患者 确诊后继续吸烟。患有慢性阻塞性肺病的吸烟者报告有很高的共生率- 尼古丁依赖、抑郁和焦虑--这些都是戒烟的障碍。拟议的研究将 开发和试行针对常见心理因素的行为干预 这些共生疾病的潜在原因，并促进COPD患者戒烟。 拟议研究的主要目标是：1)通过以下方式提炼行为治疗组件 与患者和提供者进行定性访谈，2)开发量身定制的行为治疗方法，以解决 采用单病例设计实验研究COPD患者的心理危险因素，并进行试点 多组分干预对吸烟影响的随机对照试验 结果，与最低限度加强的日常护理相比。拟议的项目将是第一个改编成 针对吸烟的慢性阻塞性肺疾病患者的心理危险因素进行行为治疗。通过 针对核心心理风险因素，行为治疗可能有助于缓冲与压力相关的 随着疾病的进展和COPD患者运动耐量的增加，肺活量增加 康复和生活质量。因此，这种干预有可能消除大量的健康问题。 减少慢性阻塞性肺病患者的负担，并最终降低与慢性阻塞性肺病相关的发病率和死亡率。 阿曼达·马修，博士，西北大学范伯格学院研究助理教授 医学，正在通过K23指导的以患者为导向的研究生涯寻求五年的支持 与开发和测试戒烟有关的培训和研究发展奖 针对慢性阻塞性肺疾病患者心理危险因素的干预。马修博士的主要职业生涯 目的是阐明心理因素影响吸烟的机制，开发新的 对患有医疗和精神疾病的吸烟者进行干预，减少与烟草有关的健康 差距。通过拟议的培训计划，马修博士将扩大她在以下方面的知识和技能 干预发展；行为RCT设计、实施和分析；以及戒烟和 治疗需要针对患有慢性阻塞性肺疾病的个人。马修博士的多学科指导团队已经 在这些内容领域表现出专业知识，并致力于马修博士的职业发展。Dr。 马修提出的工作也与行为医学研究的优先事项在 西北大学范伯格医学院预防医学系。

PROJECT SUMMARY/ABSTRACT Chronic Obstructive Pulmonary Disease (COPD) is caused primarily by smoking and smoking cessation is the first-line treatment for slowing disease progression. Despite this, nearly 50% of COPD patients continue to smoke following diagnosis. Smokers with COPD report high rates of co-occurring conditions – nicotine dependence, depression, and anxiety – which serve as barriers to quitting. The proposed research will develop and pilot test a behavioral intervention designed to target the common psychological factors underlying these co-occurring conditions and foster smoking cessation among COPD patients. Primary aims of the proposed research are to: 1) Refine behavioral treatment components through qualitative interviews with patients and providers, 2) Develop a tailored behavioral treatment to address psychological risk factors among COPD patients using single case design experiments, and 3) Conduct a pilot randomized controlled trial (RCT) to examine the effects of the multi-component intervention on smoking outcome, as compared to minimally-enhanced usual care. The proposed project will be the first to adapt a behavioral treatment to specifically target psychological risk factors among COPD patients who smoke. By addressing core psychological risk factors, the behavioral treatment may help buffer against stress associated with disease progression and increase COPD patients' exercise tolerance, engagement in pulmonary rehabilitation, and quality of life. Thus, this intervention has potential to obviate a large number of health burdens among COPD patients, and ultimately to reduce morbidity and mortality associated with COPD. Amanda Mathew, PhD, a Research Assistant Professor at Northwestern University Feinberg School of Medicine, is seeking five years of support through the K23 Mentored Patient-Oriented Research Career Development Award for training and research related to development and testing of smoking cessation interventions targeted to psychological risk factors among COPD patients. Dr. Mathew's overarching career goals are to elucidate the mechanisms by which psychological factors impact cigarette smoking, develop novel interventions for smokers with medical and psychiatric comorbidities, and reduce tobacco-related health disparities. Through the proposed training plan, Dr. Mathew will expand her knowledge and skills related to intervention development; behavioral RCT design, conduct, and analysis; and smoking cessation and treatment needs specific to individuals with COPD. Dr. Mathew's multidisciplinary mentorship team has demonstrated expertise in these content areas, and is committed to Dr. Mathew's career development. Dr. Mathew's proposed work is also well-aligned with behavioral medicine research priorities within the Department of Preventive Medicine at Northwestern University Feinberg School of Medicine.