Dyadic yoga Program for Patients with Lung Cancer Undergoing Radiotherapy and their Family Caregivers

项目摘要/摘要 肺癌是美国最常见的癌症，对男性和女性都有影响 比其他类型的癌症患者更令人衰弱的身体和心理症状。普普通通 症状包括肺功能降低、呼吸困难、疲劳、睡眠障碍和抑郁。 他们的生活质量(QOL)。鉴于这些症状，患者非常需要护理和支持。病人的 家庭照顾者是他们最重要和最有价值的支持和照顾来源；然而，照顾是身体上的 而且在情感上也很累人。事实上，家庭照顾者报告的心理困扰、疲劳和睡眠的比率很高 干扰，这可能会影响他们能够为患者提供的护理质量。给定 生活质量的相互依存性在家庭中，糟糕的照顾者生活质量可能会破坏患者的生活质量。因此，有 需要建立以患者和照顾者为目标的循证二元支持性护理计划 结果。基于我们的试点数据中令人振奋的发现，我们建议研究一种二元瑜伽项目 在肺癌患者(LC)及其家庭照顾者中。为了确定瑜伽项目的效果， 拟议的研究将随机分配患者和照顾者的二元瑜伽或二元教育 一群人。在随机化之前，患者和照顾者都将完成标准的生活质量测量。我们还将 从血液和唾液样本中收集生物标志物。患者将完成客观的身体测量 性能。根据他们的小组任务，二人组将参加瑜伽课程或健康教育 一块儿开课。两组将接受相同的干预暴露(15次，每次60分钟) 患者6周放射治疗(RT)计划疗程。在治疗期间，我们将每周评估 病人的症状。在RT结束时，1、2、3和6个月后，两组的二联体将被重新评估。在… 在为期3个月的跟踪评估中，我们还将收集定性样本，以进一步了解参与者的 经历。这项研究的主要目标是证明，在瑜伽组中，患者将表现出 更好的客观身体表现患者和照顾者都将报告生活质量有更大的改善 与二元教育组的学生相比。次要目标是检查症状的改善 负担、内分泌和免疫失调和症状管理，以及这些改善是否起到了中介作用 身体功能和生活质量结果。最后，我们考察了可能影响干预效果的因素， 这将为未来的研究提供信息，扩大这一研究计划。这一项目是迈向 管理肺癌患者及其照顾者的体能和生活质量，这是一个脆弱的问题 未被充分研究的人群。

PROJECT SUMMARY/ABSTRACT Patients with lung cancer, the most prevalent cancer in United States affecting both men and women, experience more debilitating physical and psychological symptoms than patients with other types of cancer. Common symptoms include reduced lung function, dyspnea, fatigue, sleep disturbances, and depression compromising their quality of life (QOL). In light of these symptoms, patients have a high need for care and support. Patients’ family caregivers are their most important and valued source of support and care; yet, caregiving is physically and emotionally taxing. In fact, family caregivers report high rates of psychological distress, fatigue, and sleep disturbances, which may compromise the quality of care they are able to provide to the patient. Given the interdependent nature of QOL in families, poor caregiver QOL may undermine patient QOL. Therefore, there is a need to established evidence-based dyadic supportive care programs targeting both patient and caregiver outcomes. Based on the promising findings of our pilot data, we proposed to examine a dyadic yoga program in patients with lung cancer (LC) and their family caregivers. To determine efficacy of a yoga program, the proposed research will randomly assign patient-caregiver dyads to either a dyadic yoga or a dyadic education group. Prior to randomization, both patients and caregivers will complete standard QOL measures. We will also collect biomarkers from blood and saliva samples. Patients will complete objective measures of physical performance. Based on their group assignment, dyads will either attend yoga sessions or health education sessions together. Both groups will receive the same intervention exposure (15 sessions, 60 min each) over the course of patients’ 6-week radiation treatment (RT) plans. During the treatment period, we will weekly assess patients’ symptoms. At the end of RT, 1, 2, 3, and 6-months later, dyads in both groups will be re-assessed. At the 3-month follow-up assessment, we will also collect qualitative samples to further understand participants’ experiences. The primary goal of this research is to demonstrate that, in the yoga group, patients will show better objective physical performance both patients and caregivers will report greater improvements in QOL compared to those in the dyadic education group. Secondary goals are to examine improvements in symptom burden, endocrine and immune dysregulation and symptom management and if these improvements mediate the physical function and QOL outcomes. Lastly, we examine factors that may moderate interventions effects, which will inform future studies expanding this program of research. This project represents a major step towards managing physical performance and QOL in lung cancer patients and their caregivers, a vulnerable yet understudied population.