Mind-Body Interactions in Neuro-Oncology Family Caregivers

描述(由申请人提供)：患有原发恶性脑瘤(PMBT)的人通常患有严重的功能和神经疾病，导致家庭照顾者承担照顾者的家庭、社会和经济义务。研究表明，患有其他慢性病的照顾者会因为提供护理而产生负面后果。尽管PMBT患者的发病率(和死亡率)很高，但神经肿瘤学中的照顾者问题几乎被忽视了。针对PA-05-027，本研究的目的是使用一个多学科的综合模型，匹兹堡心身中心模型，以(1)检查诊断时PMBT患者的家庭成员的心理-行为反应(即抑郁症状和睡眠)、生物反应(即血压和ihterleukins)以及整体身体健康，以及(2)描述该模型内的关系如何随时间的变化而变化，以响应家庭成员向家庭照料者转变的疾病轨迹的变化。该项目的具体目标是：1)检查照顾者的疾病特征和照顾者的心理行为反应、生物反应和整体身体健康随时间的变化(从PBMT诊断到确诊后12个月)；在这12个月期间，2)检查照顾者的个人特征如何调节照顾者的疾病特征和照顾者的心理行为反应之间的关系；3)检查照顾者的心理行为反应如何调节照顾者的疾病特征和照顾者的生物反应之间的关系；以及4)检查照顾者的生物反应如何调节他们的心理行为反应和整体身体健康之间的关系。将使用描述性纵向设计来收集数据，以解决项目的目标。将使用线性和Logistic回归分析对基线反应进行建模。将使用重复测量分析(随机系数建模)来检查随时间的变化，并将使用潜在增长曲线建模来进一步探索纵向数据。该项目与公共卫生的相关性是，在护理接受者的疾病轨迹期间的特定时间点，确定哪些护理人员容易受到其情绪和身体健康变化的影响。改善照顾者的情绪和身体健康可能会改善护理的提供和护理接受者的生活质量。

DESCRIPTION (provided by applicant): Persons with a primary malignant brain tumor (PMBT) often suffer significant functional and neurologic morbidity causing family caregivers to assume the care recipient's familial, social, and financial obligations. Research has shown that caregivers of persons with other chronic diseases develop negative consequences as a result of providing care. Despite high morbidity (and mortality) rates for persons with a PMBT, caregiver issues in neuro-oncology have been virtually ignored. In response to PA-05-027, the purposes of this study are to use a multidisciplinary, integrative model, the Pittsburgh Mind Body Center Model, to (1) examine the psycho-behavioral responses (i.e. depressive symptoms and sleep), biologic responses (i.e. blood pressure and ihterleukins) and overall physical health of family members of persons with a PMBT at the time of diagnosis, and (2) to describe how relationships within the model vary over time in response to changes in the care recipient's illness trajectory as the family member transitions to a family caregiver. The specific aims of the project are to: 1) examine how care recipients' disease characteristics and caregivers' psycho- behavioral responses, biologic responses, and overall physical health change over time (from PBMT diagnosis to 12 months after diagnosis); and during this 12-month period, to 2) examine how caregivers' personal characteristics moderate the relationship between care recipients' disease characteristics and caregivers' psycho-behavioral responses; 3) examine how caregiver psycho-behavioral responses mediate the relationship between care recipients' disease characteristics and caregivers' biologic responses; and 4) examine how caregivers' biologic responses mediate the relationship between their psycho-behavioral responses and overall physical health. A descriptive longitudinal design will be used to collect data to address the aims of the project. Linear and logistic regression analysis will be used to model baseline responses. Repeated measures analysis (random coefficients modeling) will be used to examine change over time and latent growth curve modeling will be used to further explore longitudinal data. The relevance of the project to public health is to identify caregivers at specific time-points during the care recipient's disease trajectory who are vulnerable to changes in their emotional and physical health. Improving caregivers' emotional and physical health may improve the delivery of care and quality of life for the care recipient.