Psycho-Spiritual Management for Patients with Advanced Cancer and their Family Caregivers
晚期癌症患者及其家庭照顾者的心理精神管理
基本信息
- 批准号:10734689
- 负责人:
- 金额:$ 69.41万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-09-11 至 2028-08-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAdvanced Malignant NeoplasmAffectAreaAttentionBehaviorBehavioral MedicineBehavioral SciencesCancer FamilyCancer PatientCaregiversCaringCessation of lifeCommunity HospitalsControl GroupsDataDevicesDiagnosisDiseaseDisease ProgressionDisseminated Malignant NeoplasmDistressDoseEmotionalEnrollmentEnsureExerciseFamilyFamily CaregiverFeeling hopelessFeeling suicidalFosteringFrightFutureGoalsHospice CareImmunotherapyInterventionIntervention StudiesKnowledgeLatinoLifeLiteratureMalignant NeoplasmsManualsMeasurementMeditationMental DepressionMethodsNatureOutcomePalliative CareParticipantPatient CarePatient Self-ReportPatientsPersonal SatisfactionPopulationPopulation HeterogeneityProceduresPrognosisPsychologyPsychosocial Assessment and CareRandomizedRandomized, Controlled TrialsSamplingSelf AssessmentSiteSocial supportSolidSpiritualitySupportive careSymptomsTechniquesTranslatingTranslationsTreatment EfficacyVideoconferencingWorkarmattentional controlcancer therapyclinical carecomparison groupcopingdepressive symptomsefficacious interventionefficacy trialemotional disclosureend of lifeend of life careevidence baseexperiencefollow-uphigh riskhospital careimprovedin vivoinnovationnegative affectnovelpatient populationpeacepilot testpositive emotional statepreferenceprimary outcomeprognostic valueprogramspsychologicpsychological distresspsychosocialrecruitsecondary outcomestressortooltreatment armtreatment as usualtrial comparingusual care arm
项目摘要
PROJECT SUMMARY/ABSTRACT
Given the generally incurable nature of metastatic cancer, patients and their family caregivers are at high risk of
experiencing depressive symptoms and spiritual distress (e.g., lack of meaning and peace, despair, alienation).
As caregivers struggle with their own fears and stressors, providing quality support and care to the patient may
be difficult. Moreover, psychospiritual distress is interdependent in families coping with cancer suggesting the
need for a dyadic approach to psychospiritual supportive care. Despite accumulating evidence that highlights
the value of positive psychology interventions in improving depressive symptoms and spiritual wellbeing,
evidence-based dyadic interventions are limited in the palliative care setting. To address critical knowledge gaps
and build upon our pilot work, we propose an adequately powered efficacy trial of a 4-session family-focused
meditation (FFM) intervention targeting psychospiritual outcomes. Patient-family caregiver dyads will be
randomized to either the FFM intervention, a usual care (UC) control group or a dose-matched attention control
(AC) group receiving a social support intervention. To enhance accessibility and scalability for future
dissemination, the FFM and AC interventions will be delivered via videoconferencing. To increase generalizability
of our findings, we will use a multi-site enrollment strategy and recruit families from a community hospital caring
for a diverse including underserved patient population. We will administer all study procedures including the
Patients and caregivers will complete
assessments at baseline (prior to randomization) and then again 6, 12, and 24 weeks later. Guided by our
exciting pilot findings, we propose a multi-method assessment strategy to uncover a priori intervention
mechanisms. In addition to self-reports, at baseline and the 6-week follow-up, patients and caregivers will wear
a device called the Electronically Activated Recorder (EAR), an innovative, in vivo naturalistic observation tool
that will allow us to objectively assess changes in observed behaviors in daily life as a function of group
assignment to evaluate mechanisms of intervention efficacy. We propose depressive symptoms as the primary
outcome given the prognostic value of depression in the survival of metastatic cancer patients and family
caregivers; and spiritual wellbeing as the secondary outcome as it protects against the desire for a hastened
death, hopelessness, and suicidal ideation independent of depression in patients with metastatic cancer. For
families who transition to end of life care over the course of the study, we seek to explore their experiences with
this transition and if the FFM program improves patient and caregiver psychospiritual adjustment at this crucial
timepoint. The knowledge gained from this randomized controlled trial will advance the science of behavioral
medicine, and, ultimately, inform the clinical care of a vulnerable and understudied patient-caregiver population.
intervention in English or Spanish based on participant preference.
项目摘要/摘要
鉴于转移性癌症通常不可治愈的性质,患者及其家庭护理人员面临高风险,
经历抑郁症状和精神痛苦(例如,缺乏意义与和平、绝望、异化)。
当护理人员与自己的恐惧和压力作斗争时,为患者提供高质量的支持和护理可能会
很难此外,在应对癌症的家庭中,精神上的痛苦是相互依赖的,这表明,
需要一种精神心理支持护理的二元方法。尽管有越来越多的证据表明
积极心理学干预在改善抑郁症状和精神健康方面的价值,
基于证据的二元干预措施在姑息治疗环境中受到限制。解决关键的知识差距
并建立在我们的试点工作,我们提出了一个充分的效力试验的4届家庭为重点,
冥想(FFM)干预针对心理精神的结果。患者-家庭护理者的配对将是
随机分配至FFM干预组、常规护理(UC)对照组或剂量匹配的注意力对照组
(AC)接受社会支持干预的群体。增强未来的可访问性和可扩展性
此外,实况调查和反腐败干预措施将通过视频会议提供。提高普遍性
根据我们的研究结果,我们将采用多点招募策略,从社区医院招募家庭,
包括服务不足的患者人群。我们将实施所有研究程序,包括
患者和护理人员将完成
在基线(随机化前)评估,然后在6、12和24周后再次评估。引导我们的
令人兴奋的试点结果,我们提出了一个多方法的评估策略,以揭示先验干预
机制等除了自我报告外,在基线和6周随访时,患者和护理人员将佩戴
一种名为电子激活记录器(Electronically Activated Recorder,简称EAR)的设备,一种创新的活体自然观察工具,
这将使我们能够客观地评估日常生活中观察到的行为变化,
任务是评估干预功效的机制。我们认为抑郁症状是
考虑到抑郁症对转移性癌症患者及其家属生存的预后价值,
照顾者;和精神福祉作为次要的结果,因为它保护免受欲望的加速
转移性癌症患者中与抑郁无关的死亡、绝望和自杀意念。为
在研究过程中过渡到临终关怀的家庭,我们寻求探索他们的经验,
这种过渡,如果FFM计划改善病人和照顾者的心理精神调整,在这个关键的
时间点。从这项随机对照试验中获得的知识将推动行为科学的发展。
医学,并最终为弱势和未充分研究的患者护理人员提供临床护理。
根据参与者的偏好,以英语或西班牙语进行干预。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Kathrin Milbury其他文献
Kathrin Milbury的其他文献
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{{ truncateString('Kathrin Milbury', 18)}}的其他基金
Simulation-Based Caregiving Skills Training for Family Members of High Grade Glioma Patients
高级别胶质瘤患者家属的模拟护理技能培训
- 批准号:
10509910 - 财政年份:2022
- 资助金额:
$ 69.41万 - 项目类别:
Simulation-Based Caregiving Skills Training for Family Members of High Grade Glioma Patients
高级别胶质瘤患者家属的模拟护理技能培训
- 批准号:
10693312 - 财政年份:2022
- 资助金额:
$ 69.41万 - 项目类别:
Parenting Intervention for Caregivers who Parent a Young Child while Caring for a Spouse with an Incurable Cancer.
针对在照顾患有无法治愈癌症的配偶时养育幼儿的护理人员的育儿干预。
- 批准号:
10301442 - 财政年份:2021
- 资助金额:
$ 69.41万 - 项目类别:
Improving Health Utilization and Quality of Life in Head and Neck Cancer Patients Undergoing Chemoradiation and their Family Caregivers
改善接受放化疗的头颈癌患者及其家庭护理人员的健康利用和生活质量
- 批准号:
10040568 - 财政年份:2020
- 资助金额:
$ 69.41万 - 项目类别:
Improving Health Utilization and Quality of Life in Head and Neck Cancer Patients Undergoing Chemoradiation and their Family Caregivers
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- 批准号:
10684253 - 财政年份:2020
- 资助金额:
$ 69.41万 - 项目类别:
Improving Health Utilization and Quality of Life in Head and Neck Cancer Patients Undergoing Chemoradiation and their Family Caregivers
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- 批准号:
10454943 - 财政年份:2020
- 资助金额:
$ 69.41万 - 项目类别:
Improving Health Utilization and Quality of Life in Head and Neck Cancer Patients Undergoing Chemoradiation and their Family Caregivers
改善接受放化疗的头颈癌患者及其家庭护理人员的健康利用和生活质量
- 批准号:
10263936 - 财政年份:2020
- 资助金额:
$ 69.41万 - 项目类别:
Dyadic yoga Program for Patients with Lung Cancer Undergoing Radiotherapy and their Family Caregivers
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- 批准号:
9761506 - 财政年份:2018
- 资助金额:
$ 69.41万 - 项目类别:
Dyadic yoga Program for Patients with Lung Cancer Undergoing Radiotherapy and their Family Caregivers
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- 批准号:
9979799 - 财政年份:2018
- 资助金额:
$ 69.41万 - 项目类别:
Dyadic yoga Program for Patients with Lung Cancer Undergoing Radiotherapy and their Family Caregivers
为接受放疗的肺癌患者及其家人提供的二元瑜伽课程
- 批准号:
10214568 - 财政年份:2018
- 资助金额:
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