Role of Emotional Processing in Art Therapy for Breast Cancer Palliative Care Patients: A Mechanistic Study

情绪处理在乳腺癌姑息治疗患者艺术治疗中的作用：机制研究

• 批准号: 9794138
• 负责人: Johanna Czamanski-Cohen
• 金额: $ 32.45万
• 依托单位: UNIVERSITY OF HAIFA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-26 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9794138
• 关键词: Adherence; Affect; Anti-Cholinergics; Anti-inflammatory; Antiinflammatory Effect; Arabs; Arts; Awareness; Breast Cancer Patient; Breast Cancer survivor; Breast Cancer therapy; Cancer Survivor; Communication; Cultural Backgrounds; Diagnosis; Distress; Emotional; Emotions; Ensure; Ethnic Origin; Fatigue; Frequencies; Future; Health; Healthcare; Hospitalization; Hour; Individual; Inflammatory; Israel; Malignant Neoplasms; Measures; Mediating; Mental Depression; Minority; Outcome; Pain; Palliative Care; Participant; Patient Care; Process; Psychophysiology; Psychotherapy; Quality of life; Randomized; Randomized Controlled Trials; Reporting; Research; Resolution; Rest; Role; Sample Size; Shapes; Site; Symptoms; Testing; Therapeutic; Therapeutic Intervention; Time; United States; Visual; Woman; Work; base; breast cancer diagnosis; cancer diagnosis; cancer palliative treatment; cancer therapy; coping; cost; cytokine; depressive symptoms; design; ethnic minority population; experience; follower of religion Jewish; group intervention; heart rate variability; improved; malignant breast neoplasm; persistent symptom; programs; psychological symptom; recruit; response; showing emotion; social norm; study population; symptom management; symptomatic improvement; therapy design

ABSTRACT Approximately one-third of women coping with breast cancer experience persistent symptoms of depression, pain and fatigue, which are not normative and are difficult to treat. Emotion approach coping, including awareness, acceptance and expression of emotions is related to more rapid resolution of depressive symptoms and improved health outcomes in breast cancer survivors. Since expression of emotion is inconsistent with social norms in some ethnic minorities, specifically those from a more traditional background, BC survivors from these ethno-cultural minorities are less likely to seek opportunities for emotional expression and support. Art Therapy is a form of psychotherapy that uses visual art-making as a form of expression and communication within a safe and supportive relationship, in a therapeutic setting. Art Therapy is documented in cancer settings to alleviate psychological symptoms and to reduce physical complaints. BC survivors have reported that art-making increased access to emotional content and its expression. Because Art Therapy provides the opportunity for indirect expression, it may be particularly potent with individuals from traditional and collectivist ethno-cultures. The purpose of this study is to examine emotional processing and cholinergic anti- inflammatory processes through which an AT intervention may reduce depression, pain and fatigue. To examine these emotional processing and cholinergic anti-inflammatory mechanisms, we have designed a randomized controlled study with careful controls. Responsive to PAR-14-294 on Arts-Based Approaches in Palliative Care for Symptom management, the research seeks to accomplish: AIM 1: To examine two mechanisms: 1) emotional processing and 2) cholinergic anti-inflammatory processes, through which Art Therapy reduces depression, pain and fatigue in Jewish and Arab BC survivors. Hypothesis: Participants in Art Therapy (vs sham Art Therapy (Mandala)) will experience greater increases in emotion processing (awareness, acceptance and expression), resting HRV, and regulatory cytokine expression as well as a greater decrease in pro-inflammatory cytokine expression: which in turn will mediate the effect of Art Therapy on depression, pain and fatigue. AIM 2: To examine ethno-cultural differences in the effect of Art Therapy in women from a traditional collectivist ethno-cultural background, compared to women from a more individualist western ethno-cultural background. Hypothesis: Individuals from a traditional collectivist ethno-cultural group will demonstrate a more prominent response to the Art Therapy intervention, compared to women in the more individualist western ethno-cultural group, beyond differences in traditional values. We will conduct a randomized controlled trial of 120 Jewish and 120 Arab women diagnosed with breast cancer diagnosed within the last year, recruited in Israel and randomized to undergo an 8-week program of AT compared to sham Art Therapy.

摘要 大约三分之一的乳腺癌女性会经历持续的抑郁症状， 疼痛和疲劳，这是不规范的，很难治疗。情绪方法应对，包括 情绪的意识、接受和表达与抑郁症状的更快解决有关 并改善乳腺癌幸存者的健康状况。由于情感的表达与社会的 规范在一些少数民族，特别是那些从更传统的背景，不列颠哥伦比亚省的幸存者从这些 族裔文化少数群体不太可能寻求表达情感和获得支持的机会。 艺术治疗是一种心理治疗形式，它使用视觉艺术创作作为一种表达形式， 在治疗环境中，在安全和支持的关系中进行交流。艺术疗法被记录在 癌症设置，以减轻心理症状和减少身体的投诉。BC幸存者 报告说，艺术创作增加了对情感内容及其表达的接触。因为艺术治疗 提供了间接表达的机会，它可能对来自传统和 集体主义民族文化本研究的目的是探讨情绪加工和胆碱能抗- AT干预可以减轻抑郁、疼痛和疲劳的炎症过程。 为了研究这些情绪处理和胆碱能抗炎机制，我们 设计了一项随机对照研究，并进行了仔细的对照。对基于艺术的PAR-14-294的响应 在症状管理的姑息治疗方法，该研究旨在实现： 目的1：研究两种机制：1）情绪处理和2）胆碱能抗炎过程， 艺术疗法通过艺术疗法减轻了犹太人和阿拉伯公元前幸存者的抑郁、疼痛和疲劳。 假设：艺术治疗的参与者（与假艺术治疗（曼陀罗））将经历更大的增加， 情绪处理（意识、接受和表达）、静息HRV和调节性细胞因子表达 以及促炎细胞因子表达的更大降低：这反过来将介导 艺术治疗抑郁症，疼痛和疲劳。 目的2：从传统集体主义者的角度考察艺术治疗对女性的影响的民族文化差异 民族文化背景的妇女，相比之下，来自更个人主义的西方民族文化背景的妇女。 假设：来自传统集体主义民族文化群体的个人将表现出更突出的 对艺术治疗干预的反应，与西方民族文化中的女性相比， 超越传统价值观的差异。 我们将对120名犹太和120名阿拉伯女性进行一项随机对照试验， 在过去一年内诊断出癌症，在以色列招募并随机接受为期8周的AT计划 与虚假的艺术治疗相比