CBT Training For Clinicians Providing Supportive Care For Cancer Survivors

描述(由申请人提供)：对于三分之一到一半的癌症幸存者来说，情绪和认知的障碍并不会随着治疗的结束而结束。认识到这一问题，医学研究所(IOM)在其2007年的报告《对整个患者的癌症护理：满足心理社会健康需求》中强调了解决心理社会问题(如痛苦)对提供良好的癌症护理的重要性。NCI认识到，严重缺乏训练有素的专业人员来满足这些需求。拟议的培训计划旨在通过培训为癌症幸存者提供支持性护理的卫生专业人员来实施认知-行为疗法(CBT)来减少这些生活质量问题。经经验验证的CBT干预已被发现为癌症患者和幸存者带来了显著的好处，包括减少心理痛苦。虽然我们调查的71%的卫生保健专业人员认识到CBT的有效性，但只有5%的人报告掌握了CBT技能。超过80%的人表示有很高的动力学习如何针对癌症幸存者实施CBT技术。受训者将是经过竞争挑选的有执照/证书的专业人员，包括：心理学家、社会工作者和CL护士。拟议的R-25E将测试一种结构化的CBT培训课程，其中包括授课讨论、角色扮演和反馈。课程将分3天举行，每个讲习班有40名受训人员(共8个讲习班，共320名受训人员)。将提供CBT练习册以及相关期刊文章和评论章节的副本。完成研讨会后，学员将参加每月六次的后续小组电话会议，以回顾CBT技术并讨论其进展。计划评估将涉及：获得的知识和技能、幸存者福利、受训人员和机构接受情况以及受训人员满意度。 总体目标：培训医疗保健专业人员，为癌症幸存者实施CBT，以提高他们的生活质量。具体目标：1：在讲习班前和讲习班后，使用纸笔评估学员关于CBT技术的知识，测试保健专业CBT培训讲习班的有效性；2：根据培训者对讲习班期间模拟CBT会议期间学员技能的评级，评估获得的CBT技能；3：根据培训者对第六次(也是最后一次)后续电话会议后介绍的案例所展示的技能的评估，评估培训的有效性；4：为了确定培训对最终用户的益处的有效性，接受培训的幸存者根据幸存者在CBT干预前后完成的标准化测量中的遇险评分确定；5：通过评估他们在完成所有培训后与幸存者一起继续实施CBT来评估他们对CBT的接受情况；6：确定机构对CBT培训的接受情况，如机构打算派遣其他工作人员参加未来的CBT培训讲习班；7：评估学员对CBT专业教育计划的满意度。 相关性：即使在治疗结束后，许多癌症幸存者仍在遭受情绪上的痛苦。拟议的专业癌症教育计划通过培训负责其支持性服务的临床医生实施认知-行为疗法，努力为这些幸存者提供尽可能好的护理。

DESCRIPTION (provided by applicant): For between one-third and one-half of all cancer survivors, disturbances in mood and cognition do not end with the conclusion of treatment. Recognizing this problem, the Institute of Medicine (IOM) has emphasized in its 2007 report, "Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs," the importance of addressing psychosocial issues, such as distress, to providing good cancer care. The NCI has recognized that there is a severe lack of trained professionals to address these needs. The proposed training program seeks to reduce these quality of life problems by training health professionals providing supportive care to cancer survivors to implement of Cognitive-Behavioral Therapy (CBT). Empirically-validated CBT interventions have been found to yield significant benefits for cancer patients and survivors, including reduction of psychological distress. Although 71% of health care professionals we polled recognized the usefulness of CBT, only 5% reported mastery of CBT skills. And over 80% expressed high motivation in learning how to implement CBT techniques targeted for cancer survivors. Trainees will be competitively selected licensed/credentialed professionals, including: psychologists, social workers, and CL nurses. The proposed R-25E will test a structured CBT training curriculum that includes didactic discussion, role playing and feedback. The curriculum will be presented across 3-day workshops with 40 trainees at each workshop (for a total of 320 trainees across a total of 8 workshops). CBT workbooks and copies of relevant journal articles and review chapters will be provided. After completing the workshop, trainees will participate in six monthly follow-up group phone conferences to review CBT techniques and to discuss their progress. Program evaluation will address: knowledge and skills acquired, survivor benefit, trainee and institutional up-take, and trainee satisfaction. Overarching goal: to train healthcare professionals to implement CBT for cancer survivors in order to improve their quality of life. Specific aims: 1: To test the effectiveness of healthcare professional CBT training workshops using paper-and-pencil evaluations of trainee knowledge of CBT techniques, administered pre- and post-workshops; 2: To assess CBT skills gained based on trainer ratings of trainee skill during mock CBT sessions carried out during workshops; 3: To evaluate the effectiveness of training based on trainer assessment of skill demonstrated during presentation of a case presented after the sixth (and final) follow-up phone conference call; 4: To determine the effectiveness of training in terms of benefit for end-users, the survivors treated by trainees, as determined by survivors' ratings of distress on standardized measures completed before and after the CBT intervention; 5: To evaluate trainee uptake of CBT through an assessment of their continued implementation of CBT with survivors after completion of all training; 6: To determine institutional uptake of the CBT training as indicated by the institution's intention to send other staff members to future CBT training workshops; 7: To assess trainee satisfaction with the CBT professional education program. Relevance: Even after treatment is over, many cancer survivors continue to suffer from emotional distress. The proposed professional cancer education program strives to provide these survivors the best possible care by training the clinicians responsible for their supportive services to implement Cognitive-Behavioral Therapy.