Biological and Psychosocial Mechanisms of Cancer Caregivers' Elevated Health Risk

癌症护理人员健康风险升高的生物和心理社会机制

基本信息

批准号：
10217259
负责人：
YOUNGMEE KIM
金额：
$ 47.06万
依托单位：
UNIVERSITY OF MIAMI CORAL GABLES
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-26 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10217259
关键词：
Address Affect Affective Arousal Biological Biological Markers Cancer Patient Cancer Survivor Cardiovascular system Caregivers Chronic Disease Development Disease Distress Family Caregiver Family member Female Gender Health Health Care Visit Health Promotion Heterosexuals Hydrocortisone Immune system Influentials Intervention Investigation Life Link Malignant Neoplasms Modeling Moods Morbidity - disease rate Neurosecretory Systems Outcome Outcome Measure Pathway interactions Patient Self-Report Patients Pattern Persons Physiological Population Preparation Process Public Health Recovery Regulation Research Rest Resting Phase Risk Role Salivary Self Management Sleep Sleep disturbances Speech Standardization Stress Subgroup Testing Touch sensation Translating Woman biological adaptation to stress colon cancer patients depressive symptoms heart rate variability high risk improved male member mortality multilevel analysis negative affect negative mood novel premature prospective psychological distress psychosocial response stress management stress reactivity stress reduction stressor

项目摘要

Project Summary/Abstract Cancer affects not only those with the disease, but also their family members. Family caregivers are known to have compromised health, as the detrimental impact of patients' cancer on their caregivers is substantial. Studies have documented the patient's distress relates to the caregiver's poorer health and vice versa, suggesting that cancer caregivers' health is an interpersonal, dyadic problem. Unknown are when and how the dyadic, cross-over effects occur. Stress regulation among cancer caregivers and their patients is interdependent, as is the caregiver-patient relationship itself. This dyadic stress regulation occurs when members of a dyad mutually calm each other's stress reactions and dampen negative affect and physiological arousal (coregulation) or mutually increasing those outcomes (coagitation). We propose that greater stress coregulation protects against adverse health outcomes, whereas greater stress coagitation exacerbates them. This project will examine dyadic stress regulation between cancer caregivers and their patients, and test coregulation and coagitation as predictors of health outcomes. Coregulation/coagitation will be quantified by cardiovascular (heart rate variability: HRV), neuroendocrine (salivary cortisol), and self-reported affective reactivity and regulation, in response to a standardized stress situation that is relevant both to health and to close relationships. We will then examine prospectively the extent to which the indicators of coregulation for this discrete stressor relate to daily outcomes (mood, diurnal cortisol, and sleep) and interim health outcomes (depressive symptoms, resting HRV, and healthcare visits), and the degree to which gender moderates such effects. A total of 120 colorectal cancer (CRC) patients (60 male and 60 female) and their heterosexual caregiver (120 dyads) will participate. Understanding underlying biological and psycholgoical mechanisms is critical for identifying cancer caregivers and their patients who are at most risk for poor health due to their mutual stress regulation patterns. Findings of this project will be readily translated to development of novel interventions pertaining to effective and mutual management of stress in daily life and dyadic influences on health promotion. Those interventions will aim helping one another to better modulate and manage stress and optimizing beneficial effects of coregulation of cancer-related stress on better health. These tailored-and-targeted interventions will help caregivers identify when and how they should engage in stress self-management in the context of illness trajectory of their relative with cancer. They will also aim at reducing premature morbidity and mortality, particularly related to dysregulated cardiovascular, neuroendocrine, and immunologic systems, and psychological distress, among persons touched by cancer and other chronic illness, thereby improving public health.

项目摘要/摘要癌症不仅影响患有疾病的人，而且影响其家人。众所周知家庭护理人员由于患者癌症对护理人员的有害影响是很大的，因此健康损害了健康。研究记录了患者的痛苦与看护人的健康状况较差有关，反之亦然，表明癌症护理人员的健康是人际交往的二元问题。未知是何时以及如何发生了二元，跨界效应。癌症护理人员及其患者之间的压力调节是相互依存，照顾者与患者关系本身也是如此。当这种二元应力调节发生时二元成员相互平息彼此的压力反应，并抑制负面影响和生理唤醒（核心调节）或相互增加这些结果（凝结）。我们提出更大的压力核心调节可防止不利的健康结果，而更大的压力凝结会加剧它们。该项目将检查癌症护理人员及其患者之间的二元压力调节，并测试凝结和凝结作为健康结果的预测指标。核调节/凝结将通过心血管（心率可变性：HRV），神经内分泌（唾液皮质醇）和自我报告的情感反应性和调节，响应与健康和与健康相关的标准压力状况亲密关系。然后，我们将前瞻性地检查核心调节指标这种离散的压力源与每日结果（情绪，昼夜皮质醇和睡眠）和临时健康结果有关（抑郁症状，休息HRV和医疗访问）以及性别适度的程度效果。共有120例结直肠癌（CRC）患者（60名男性和60名女性）及其异性恋者护理人员（120个二元组）将参加。了解潜在的生物学和心理学机制对于识别癌症护理人员至关重要由于他们的相互压力调节模式，他们的患者最多有健康状况不佳的患者。发现这个项目的中很容易转化为与有效和相互的新型干预措施的发展管理日常生活中的压力和对健康促进的二元影响。这些干预措施将针对互相帮助更好地调节和管理压力，并优化对调节的有益效果与癌症相关的压力对更好的健康。这些量身定制的干预措施将帮助看护人确定在疾病轨迹的背景下，他们何时以及如何进行压力自我管理癌症。他们还将旨在降低过早的发病率和死亡率，特别是与心血管，神经内分泌和免疫系统的失调，心理困扰，受到癌症和其他慢性疾病感动的人，从而改善了公共卫生。

项目成果

期刊论文数量（19）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Only the Lonely: Expression of Proinflammatory Genes Through Family Cancer Caregiving Experiences.

DOI：
10.1097/psy.0000000000000897
发表时间：
2021-02-01
期刊：
Psychosomatic medicine
影响因子：
3.3
作者：
Kim Y;Cole SW;Carver CS;Antoni MH;Penedo FJ
通讯作者：
Penedo FJ

Four-symptom model of medical-related posttraumatic stress among adult cancer patients.

成年癌症患者医疗相关创伤后应激的四症状模型。

DOI：
10.1037/hea0001187
发表时间：
2022
期刊：
Health psychology : official journal of the Division of Health Psychology, American Psychological Association
影响因子：
0
作者：
Mitchell,Hannah-Rose;Kim,Youngmee;Llabre,MariaM;Ironson,Gail
通讯作者：
Ironson,Gail

Caregiving stress and burden associated with cardiometabolic risk in family caregivers of individuals with cancer.

DOI：
10.1080/10253890.2022.2037548
发表时间：
2022-01
期刊：
Stress (Amsterdam, Netherlands)
影响因子：
0
作者：
通讯作者：

Roles of age and sources of cancer caregiving stress in self-reported health and neuroendocrine biomarkers.

DOI：
10.1080/08870446.2020.1800009
发表时间：
2021-08
期刊：
PSYCHOLOGY & HEALTH
影响因子：
3.3
作者：
Mitchell, Hannah-Rose;Kim, Youngmee;Carver, Charles S.;Llabre, Maria M.;Ting, Amanda;Mendez, Armando J.
通讯作者：
Mendez, Armando J.

Healthcare professionals' perspectives on the unmet needs of cancer patients and family caregivers: global psycho-oncology investigation.