Child Coping during Pediatric Oncology Treatment Procedures

儿童在小儿肿瘤治疗过程中的应对

• 批准号: 7751556
• 负责人: Felicity Harper
• 金额: $ 7.6万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-10 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7751556
• 关键词: Address; Affect; Aftercare; Aggressive behavior; Anxiety; Archives; Behavior; Behavioral; Cancer Patient; Child; Child Behavior; Classification; Clinic Visits; Code; Communication; Coping Behavior; Data; Data Analyses; Development; Distress; Family; Funding; Future; Goals; Grant; Intervention; Long Term Survivorship; Malignant Childhood Neoplasm; Malignant Neoplasms; Mediating; Medical; Nurses; Outcome; Parents; Patient Self-Report; Pediatric Oncology; Physicians; Plant Roots; Practice Guidelines; Procedures; Process; Quality of life; Reaction; Research; Risk; Risk Assessment; Role; Spinal Puncture; Survivors; System; Temperament; Testing; Time; Training; Variant; Video Recording; Visit; abstracting; base; cancer therapy; coping; depression; effective intervention; experience; improved; indexing; psychosocial; public health relevance; resilience; response; stressor; survivorship; therapy design; therapy development; trait

DESCRIPTION (provided by applicant): Causes and Consequences of Child Coping during Pediatric Oncology Treatment Episodes: A Secondary Data Analysis ABSTRACT Many pediatric cancer patients experience serious psychosocial problems during and after treatment. Designing interventions to reduce these problems and improve the quality of long-term survivorship requires understanding the origins of stressors underlying these psychosocial problems. Treatment episodes (defined as the time before, during, and immediately following treatment procedures) are one of the most stressful aspects of pediatric cancer, and child long-term outcomes are rooted in the treatment experience. As a result, children's negative responses to treatment episodes may place them at greater risk for negative psychosocial outcomes after treatment. Findings from our previous NIH-funded research show that differences in parent and child attributes (i.e., trait affect, temperament, resilience), child behavior problems (i.e., anxiety, depression, somatic problems, aggression), and parent state affect and communication are associated with children's global ratings of distress during treatment episodes. However, little is known about the role of child coping behaviors during these episodes and how these behaviors might mediate these relationships. Our long-term goal is to understand how factors that exist prior to treatment episodes and interpersonal processes during episodes influence child coping, and in turn, child responses to treatment episodes (i.e., distress behaviors during episodes and quality of life post-episode). Therefore, our primary objective in the proposed study is to extend our previous research with a secondary analysis of previously video-recorded pediatric oncology treatment episodes (and related parent and child variables) to achieve the following aims: Aim #1: Further develop and refine a coding system to systematically observe and analyze child coping and distress behaviors during treatment episodes Aim #2: Apply this coding system to an existing archive of video-recorded pediatric oncology treatment episodes that include parents and children (N = 41) Aim #3: Explore and empirically test relationships between observational ratings of child coping behaviors during treatment episodes and: (a) parent and child dispositional attributes, (b) child behavior problems, (c) parent communication and affect during episodes, and (d) child distress during treatment episodes (i.e., observed ratings of specific distress behaviors; global ratings by parents, nurses, children; and observed global ratings by trained coders) and child quality of life after treatment episodes. Our overarching research goal is to develop effective interventions to reduce distress and improve quality of life for pediatric cancer patients. This goal requires an improved understanding of the causes and consequences of children's coping during treatment episodes. We expect our proposed research to provide direct, empirical evidence to inform the development of future interventions to enhance child coping, thereby reducing distress during episodes and improving the long-term quality of life for survivors and their families. PUBLIC HEALTH RELEVANCE: Project Narrative Previous research shows that children's cancer treatment experiences are a factor in their long-term well- being and quality of survivorship. This study seeks to better understand the causes and the consequences of differences in children's coping during treatment episodes. We will refine and apply an observational coding system to an archive of previously collected video-recordings of child treatment visits and then analyze the relationships between child coping behaviors and several child and parent factors prior to, during, and following the treatment. We expect the findings of our proposed research to provide direct evidence to inform the development of interventions to facilitate children's positive coping during treatment episodes, thereby reducing their distress during episodes and improving the long-term quality of life for survivors and their families.

描述（由申请人提供）：儿科肿瘤学治疗过程中儿童应对的原因和后果：二次数据分析摘要许多儿科癌症患者在治疗期间和治疗后经历了严重的社会心理问题。设计干预措施以减少这些问题并提高长期生存的质量，需要了解这些社会心理问题的压力源的起源。治疗发作（定义为治疗程序之前，期间和立即之后的时间）是小儿癌症最受压力的方面之一，儿童的长期结局植根于治疗经验。结果，儿童对治疗发作的负面反应可能会使他们在治疗后会面临负面的社会心理结局的风险。我们以前由NIH资助的研究中的发现表明，父母和子女属性（即特征影响，气质，韧性），儿童行为问题（即焦虑，抑郁，抑郁，体细胞问题，侵略）以及父母状态和沟通的差异与治疗期间儿童的全球痛苦等级有关。但是，对于这些情节中儿童应对行为的作用以及这些行为如何介导这些关系的作用知之甚少。我们的长期目标是了解在治疗事件发作之前存在的因素和情节期间的人际交往过程如何影响儿童应对，进而会影响儿童对治疗事件的反应（即，情节后的情节和情节期间的遇险行为）。 Therefore, our primary objective in the proposed study is to extend our previous research with a secondary analysis of previously video-recorded pediatric oncology treatment episodes (and related parent and child variables) to achieve the following aims: Aim #1: Further develop and refine a coding system to systematically observe and analyze child coping and distress behaviors during treatment episodes Aim #2: Apply this coding system to an existing archive of video-recorded pediatric oncology treatment episodes that include parents and children (N = 41) Aim #3: Explore and empirically test relationships between observational ratings of child coping behaviors during treatment episodes and: (a) parent and child dispositional attributes, (b) child behavior problems, (c) parent communication and affect during episodes, and (d) child distress during treatment episodes (i.e., observed ratings of specific distress behaviors; global ratings by parents, nurses, children; and观察到训练有素的编码人员的全球评级）和治疗后的儿童生活质量。我们的总体研究目标是制定有效的干预措施，以减少儿科癌症患者的困扰并改善生活质量。该目标需要改善对治疗事件中儿童应对的原因和后果的理解。我们希望我们提出的研究提供直接的经验证据，以告知未来干预措施以增强儿童应对的发展，从而减少情节中的困扰，并改善幸存者及其家人的长期生活质量。 公共卫生相关性：项目叙事先前的研究表明，儿童的癌症治疗经历是他们长期福祉和生存质量的一个因素。这项研究旨在更好地了解治疗事件中儿童应对差异的原因和后果。我们将完善并将观察性编码系统应用于先前收集的儿童治疗访问视频录制的档案，然后在治疗之前，之中和之后分析儿童应对行为与几个儿童和父母因素之间的关系。我们期望我们提出的研究的发现提供直接证据，以告知开发干预措施，以促进儿童在治疗事件中的积极应对，从而减少发作期间的困扰并改善幸存者及其家人的长期生活质量。