Behavioral and Psychosocial Effects on Study Outcomes in End-Stage Cancer Treatment (BEST End-Stage Cancer Study)

行为和社会心理对末期癌症治疗研究结果的影响（最佳末期癌症研究）

• 批准号: 10681336
• 负责人: Holly Gwen Prigerson
• 金额: $ 94.95万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2029-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10681336
• 关键词: Academy; Address; Advance Care Planning; Award; Behavioral; Cancer Patient; Caregivers; Caring; Cause of Death; Cessation of life; Clinical; Communication; Data; Decision Making; Disclosure; Disparity; Distress; Effectiveness; Emotional; Ensure; Equity; Family member; Frequencies; Inferior; Inherited; Intervention; Love; Malignant Neoplasms; Medical; Medicine; Mental Health; Oncologist; Outcome; Outcome Study; Pain; Patients; Persons; Prognosis; Psychosocial Factor; Public Health; Research; Research Personnel; Resources; Spiritual care; Testing; Treatment/Psychosocial Effects; United States; black patient; cancer care; cancer health disparity; cancer risk; cancer therapy; chemotherapy; end of life; end of life care; end stage disease; ethnic minority population; improved; overtreatment; palliate; palliative chemotherapy; patient prognosis; prognostic; psychosocial; psychosocial adjustment; racial minority population; theories

Behavioral and Psychosocial Effects on Study Outcomes in End-Stage Cancer Treatment (aka, the BEST End-Stage Cancer Study) Project Summary Despite great strides that have been made in the understanding and treatment of cancer, the number of cancer deaths remains on the rise and cancer remains the 2nd leading cause of death in the United States (US). Not only is the number of people dying of cancer increasing, but the quality of those deaths is alarmingly poor. End-of-life (EoL) care in the US has been deemed a public health crisis by the National Academy of Medicine -- a conclusion bolstered by disturbing findings from my group. My research has shown that end-stage cancer patients receive chemotherapy troublingly close to death, that end-stage cancer patients are shockingly uninformed of their prognosis and the harms of EoL treatments, that racial/ethnic minority groups receive dramatically inferior EoL cancer care, and that severe emotional pain and suffering remain largely unchecked. The current Outstanding Investigator Award (OIA) research has identified and targeted psychosocial factors to address these problems; the results have proved paradigm-shifting and practice-changing. For example, we showed that: 1) “palliative chemotherapy” does not “palliate” and may actually do more harm than good -> highlighting the need for oncologists to recognize the harms of “overtreatment” and refrain from prescribing chemotherapy to patients they deem close to death; 2) oncologist prognostic communication can improve patient prognostic understanding and lead to more informed, value-concordant EoL care, but it occurs infrequently, and ineffectively –> our Oncolo-GIST approach as a simple, effective way oncologists can feel comfortable communicating the gist of a patient’s prognosis; 3) that “one size does not fit all” in addressing disparities in EoL cancer care->our Divine Intervention targeting black patients’ medical mistrust and spiritual care needs as a way to promote advance care planning (ACP); 4) that psychosocial distress is an important influence on, as much as outcome of, EoL decision-making->our EMPOWER psychosocial intervention targeting “experiential avoidance” to promote caregiver psychosocial adjustment and engagement in ACP. Going forward, this OIA will focus on: 1) oncologist communication; 2) cancer disparities; and 3) psychosocial distress. I will leverage data, theories,and the clinical and scholarly resources (colleagues and collaborators) developed under the auspices of the current OIA to: improve oncologist delivery of high quality EoL cancer care; increase the frequency and effectiveness of their prognostic disclosures; promote cancer patients’ prognostic understanding; ensure the equitable delivery of EoL cancer care; and reduce psychosocial distress of patients and caregivers to enhance their mental health and promote their engagement in ACP. Renewal of this OIA will enable me to conduct research helping to ensure that dying cancer patients and their caregivers receive the highest quality of EoL cancer care possible.

行为和社会心理对终末期癌症治疗结果的影响

项目成果

Family Relationships and Psychosocial Dysfunction Among Family Caregivers of Patients With Advanced Cancer.

• DOI: 10.1016/j.jpainsymman.2016.07.006
• 发表时间: 2016-12
• 期刊: Journal of pain and symptom management
• 影响因子: 4.7
• 作者: Nissen KG;Trevino K;Lange T;Prigerson HG
• 通讯作者: Prigerson HG

Bereavement Follow-Up After the Death of a Child as a Standard of Care in Pediatric Oncology.

• DOI: 10.1002/pbc.25700
• 发表时间: 2015-12
• 期刊: Pediatric blood & cancer
• 影响因子: 3.2
• 作者: Lichtenthal WG;Sweeney CR;Roberts KE;Corner GW;Donovan LA;Prigerson HG;Wiener L
• 通讯作者: Wiener L

Associations between dementia diagnosis and end-of-life care utilization.

• DOI: 10.1111/jgs.17952
• 发表时间: 2022-10
• 期刊: JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
• 影响因子: 6.3
• 作者: Luth, Elizabeth A.;Manful, Adoma;Prigerson, Holly G.;Xiang, Lingwei;Reich, Amanda;Semco, Robert;Weissman, Joel S.
• 通讯作者: Weissman, Joel S.

Evaluating Quality Metrics for the Care of Patients With Blood Cancer Who Are Near Death.

评估濒临死亡的血癌患者护理的质量指标。

• DOI: 10.1200/jco.2016.68.8911
• 发表时间: 2016
• 期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
• 作者: Trevino,KellyM;Martin,Peter;Prigerson,HollyG
• 通讯作者: Prigerson,HollyG

Curative, Life-Extending, and Palliative Chemotherapy: New Outcomes Need New Names.

• DOI: 10.1634/theoncologist.2017-0041
• 发表时间: 2017-08
• 期刊: The oncologist
• 作者: Neugut AI;Prigerson HG
• 通讯作者: Prigerson HG