A Multimethod Approach to Understanding the Biopsychosocial Underpinnings of Chronic Cancer Pain

了解慢性癌痛的生物心理社会基础的多种方法

• 批准号: 10231965
• 负责人: Katie Fitzgerald Jones
• 金额: $ 3.25万
• 依托单位: BOSTON COLLEGE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-18 至 2023-01-17
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10231965
• 关键词: Achievement; Acute; Award; Awareness; Biological; Biological Factors; Biological Models; Cancer Etiology; Cancer Pain Management; Cancer Survivor; Chronic Cancer Pain; Clinical; Cognitive Therapy; Combined Modality Therapy; Complex; Development; Distress; Early Diagnosis; Early treatment; Fellowship; Fright; Future; General Population; Goals; Growth; Health; Individual; Intervention; Knowledge; Literature; Malignant Neoplasms; Mentors; Methodology; Mission; Modeling; National Institute of Nursing Research; Nature; Nurses; Operative Surgical Procedures; Opioid; Pain; Pain Research; Pain interference; Pain management; Persons; Pharmacological Treatment; Phase; Population; Prevalence; Psychological Factors; Psychological Models; Public Health; Qualitative Methods; Quality of life; Radiation; Recurrence; Reporting; Research; Risk; Safety; Scientist; Severities; Study models; Symptoms; Time; Training; Trauma; United States; Work; alternative treatment; biopsychosocial; biopsychosocial factor; cancer care; cancer complication; cancer diagnosis; cancer pain; cancer survival; cancer therapy; career development; chemotherapy; chronic pain; coping; evidence base; experience; health care service utilization; improved; improved functioning; opioid epidemic; opioid therapy; pain catastrophizing; pain model; pain reduction; pain self-management; patient oriented; primary outcome; psychologic; secondary outcome; side effect; skills; social; social factors; social model; symptom science; treatment adherence; treatment strategy

Project Summary For many of the 26 million cancer survivors living in the United States today, lingering treatment-related symptoms pose a considerable problem. One such symptom is chronic pain, which is twice as prevalent in cancer survivors than in the general population, and has been shown to reduce quality of life (QoL), lower treatment adherence to cancer surveillance, and contribute to higher healthcare utilization. Although there is increased awareness of the magnitude and ramification of chronic cancer pain, what is not known are the unique cancer-specific factors that contribute to the chronic-cancer pain experience. Biological, social, and psychological (BPS) factors heavily influence chronic pain in non-cancer populations. However, cancer pain has typically been excluded from chronic pain studies, and as such, multimodal treatment strategies for cancer survivors are lacking. Due to a lack of alternative treatments, chronic cancer pain management relies on a biomedical model with opioid management being the cornerstone of treatment. As a consequence and despite little evidence to support this practice, cancer survivors are prescribed long-term opioid therapy at five times the rate of the general population but continue to report undertreated pain. Although psychological approaches such as cognitive-behavioral therapy and pain self-management have shown promising results in the general population, these have not been adapted to cancer survivors who likely have a unique chronic pain experience, due to cancer-specific factors, including the fear of recurrence and cancer-related distress. Without a clear understanding of the cancer-specific factors that drive the experience of chronic cancer pain and a deeper understanding of the lived experience of cancer survivors with chronic pain, the ability to develop effective multimodal treatments to reduce pain and improve function and quality of life is extremely limited. This fellowship award will allow the applicant to gain the knowledge and skills needed to work towards the achievement of her long-term goal; to produce actionable knowledge to improve pain management, quality of life and enhance opioid safety in individuals with cancer. The short-term goal of this study is to use a multimethod approach to 1) describe the lived experience of chronic pain in cancer survivors and 2) identify the unique biopsychosocial factors that are associated with the pain experience among cancer survivors with chronic pain. The central hypothesis is that unique cancer-specific factors will impact the chronic cancer pain experience, and therefore, can be targets of future interventions. This training award will allow the applicant to build on her clinical background in the management of cancer pain and expand her research skills in symptom science through the use of quantitative and qualitative methods. The applicant has assembled a mentoring team composed of interdisciplinary experts with strong methodologic backgrounds in cancer pain research, symptom science, and cancer distress. The applicant's career development goals are to become an independent nurse scientist and a leader in the field of cancer pain research.

项目摘要 对于今天生活在美国的2600万癌症幸存者中的许多人来说， 症状造成了相当大的问题。其中一种症状是慢性疼痛，在美国， 癌症幸存者比一般人群，并已被证明降低生活质量（QoL）， 治疗坚持癌症监测，并有助于更高的医疗保健利用。虽然 随着人们对慢性癌痛的程度和后果的认识不断提高， 独特的癌症特异性因素，有助于慢性癌症疼痛的经验。生物的，社会的， 心理（BPS）因素严重影响非癌症人群的慢性疼痛。然而，癌症疼痛 通常被排除在慢性疼痛研究之外，因此，癌症多模式治疗策略 缺少幸存者。由于缺乏替代治疗，慢性癌症疼痛管理依赖于 生物医学模式，阿片类药物管理是治疗的基石。因此，尽管 几乎没有证据支持这种做法，癌症幸存者被规定长期阿片类药物治疗五次 一般人群的比率，但继续报告治疗不足的疼痛。虽然心理学方法 如认知行为疗法和疼痛自我管理已经显示出有希望的结果， 人口，这些还没有适应癌症幸存者谁可能有一个独特的慢性疼痛的经验， 由于癌症特有的因素，包括对复发的恐惧和癌症相关的痛苦。没有明确 了解癌症特异性因素，推动慢性癌症疼痛的经验和更深层次的 了解患有慢性疼痛的癌症幸存者的生活经历， 用于减轻疼痛和改善功能和生活质量的多模式治疗极其有限。这 奖学金将使申请人获得所需的知识和技能， 实现她的长期目标;产生可操作的知识，以改善疼痛管理， 提高癌症患者的阿片类药物安全性。本研究的短期目标是使用 多方法1）描述癌症幸存者慢性疼痛的生活经历，2）确定 独特的生物心理社会因素与癌症幸存者的疼痛经历相关， 慢性疼痛中心假设是独特的癌症特异性因素会影响慢性癌症疼痛 经验，因此可以成为未来干预的目标。该培训奖将允许申请人 建立在她的临床背景，在癌症疼痛的管理，并扩大她的研究技能，在症状 科学通过使用定量和定性的方法。申请人已经组建了一个指导团队， 团队由在癌症疼痛研究方面具有强大方法学背景的跨学科专家组成， 症状科学和癌症困扰。申请人的职业发展目标是成为 独立的护士科学家和癌症疼痛研究领域的领导者。