Acceptance and Commitment Therapy for Fatigue Interference in Advanced Gastrointestinal Cancer Patients and Caregiver Burden

晚期胃肠癌患者疲劳干扰和护理人员负担的接受和承诺疗法

• 批准号: 9804281
• 负责人: Catherine E Mosher
• 金额: $ 20.55万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-06-13 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9804281
• 关键词: Achievement; Address; Adult; Advanced Malignant Neoplasm; Affect; American; Awareness; Behavior Therapy; Breast Cancer Patient; Cancer Family; Cancer Intervention; Cancer Patient; Caregiver Burden; Caregivers; Cognition; Cognitive Therapy; Colorectal; Diagnosis; Disease; Distant; Distress; Education; Esophageal; Evidence based intervention; Exercise; Family Caregiver; Fatigue; Feeling; Foundations; Geography; Goals; Health; Healthcare; Impairment; Individual; Intervention; Intervention Trial; Joints; Link; Liver; Malignant Neoplasms; Malignant neoplasm of gastrointestinal tract; Malignant neoplasm of ovary; Malignant neoplasm of prostate; Meditation; Mental Health Services; Meta-Analysis; Metastatic breast cancer; Methods; Moods; Neurobehavioral Manifestations; Outcome; Pancreas; Participant; Patients; Persons; Pharmacology; Pilot Projects; Population; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recording of previous events; Reporting; Research; Resources; Role; Sampling; Self Care; Sleep; Sleep Disorders; Source; Symptoms; Telephone; Testing; Therapeutic Intervention; Thinking; Time; Translations; Treatment Efficacy; Woman; Work; adherence rate; anxiety symptoms; base; care giving burden; caregiving; chemotherapy; colon cancer patients; coping; depressive symptoms; disability; disabling symptom; experience; flexibility; functional disability; gastrointestinal; health goals; health service use; improved; innovation; intervention effect; malignant breast neoplasm; malignant stomach neoplasm; men; metastatic colorectal; mindfulness; mindfulness meditation; neglect; novel; physical conditioning; physical symptom; pilot trial; post intervention; primary outcome; programs; psychologic; reduce symptoms; secondary outcome; therapy design

Project Summary/Abstract Fatigue interference with activities, mood, and cognition is one of the most prevalent and distressing concerns of advanced gastrointestinal (GI) cancer patients. As fatigue interferes with patient functioning, family caregivers often report feeling burdened by increasing responsibilities. Evidence-based interventions addressing cancer patient fatigue interference and caregiver burden are lacking. In pilot studies, Acceptance and Commitment Therapy (ACT) has shown potential for reducing symptom-related suffering in cancer patients. We recently conducted a pilot study in metastatic breast cancer that tested a novel ACT intervention combining acceptance and mindfulness exercises (e.g., meditations, performing activities with greater awareness) with identification of personal values and engagement in activities consistent with these values. This telephone-based intervention showed strong evidence of feasibility, acceptability, and promise for reducing fatigue interference with activities, mood, and cognition. The proposed pilot study builds upon this patient-focused work to test a novel, dyadic ACT intervention for both advanced GI cancer patients with moderate-severe fatigue interference and their family caregivers with significant caregiving burden. In this trial, 40 patient-caregiver dyads will be randomly assigned in equal numbers to either the ACT intervention or an education/support control condition. Dyads in both conditions will attend six weekly 50-minute telephone sessions. Outcomes will be assessed at baseline, 2 weeks post-intervention, and 3 months post-intervention. We will evaluate the feasibility, acceptability, and preliminary efficacy of ACT on improving patient fatigue interference and caregiver burden. Secondary outcomes include patient sleep interference and patient and caregiver engagement in daily activities, psychological flexibility, and quality of life. We will also explore the effects of ACT on patient and caregiver physical and mental health service use. Study findings will inform an R01 application to conduct a large-scale trial of intervention efficacy. Results will also provide a foundation for a program of research focused on the novel application of ACT to symptom interference with functioning and caregiver burden in advanced cancer.

项目概要/摘要 疲劳对活动、情绪和认知的干扰是最普遍和最令人痛苦的问题之一 晚期胃肠道（GI）癌症患者。由于疲劳会影响患者的功能，家人 护理人员经常报告说，他们因责任的增加而感到负担沉重。循证干预措施 缺乏解决癌症患者疲劳干扰和护理人员负担的问题。在试点研究中，验收 承诺疗法 (ACT) 已显示出减少癌症症状相关痛苦的潜力 患者。我们最近对转移性乳腺癌进行了一项试点研究，测试了一种新型 ACT 干预措施 结合接受和正念练习（例如冥想、以更大的力度进行活动） 意识），识别个人价值观并参与符合这些价值观的活动。 这种基于电话的干预措施显示出强有力的证据，表明其可行性、可接受性和承诺 减少疲劳对活动、情绪和认知的干扰。拟议的试点研究以此为基础 以患者为中心的工作，旨在测试一种新颖的二元 ACT 干预措施，用于治疗患有以下疾病的晚期胃肠道癌症患者： 中重度疲劳干扰及其家庭照顾者有较大的照顾负担。在这次审判中， 40 名患者-护理人员二人组将被随机分配到相同数量的 ACT 干预组或 教育/支持控制条件。两种情况下的夫妻都将每周参加六次 50 分钟的电话会议 会议。将在基线、干预后 2 周和干预后 3 个月评估结果。 我们将评估ACT改善患者疲劳的可行性、可接受性和初步疗效 干扰和照顾者负担。次要结果包括患者睡眠干扰以及患者和 护理人员日常活动的参与度、心理灵活性和生活质量。我们还将探索 ACT 对患者和护理人员身心健康服务使用的影响。研究结果将告知 应用R01进行大规模干预疗效试验。结果也将为 一项研究计划，重点关注 ACT 在症状干扰功能和功能方面的新应用 晚期癌症的护理人员负担。