Mind-Body Interactions in Neuro-Oncology Family Caregivers

描述（由申请人提供）：患有原发性恶性脑肿瘤（PMBT）的人通常患有严重的功能和神经系统疾病，导致家庭照顾者承担照顾接受者的家庭，社会和经济义务。研究表明，其他慢性病患者的照料者在提供照料的过程中会产生负面后果。尽管PMBT患者的发病率（和死亡率）很高，但神经肿瘤学中的护理问题实际上被忽视了。为了响应PA-05-027，本研究的目的是使用一个多学科的综合模型，即匹兹堡身心中心模型，来(1)检查诊断时PMBT患者家庭成员的心理行为反应（即抑郁症状和睡眠），生物反应（即血压和白介素）和整体身体健康；(2)描述当家庭成员转变为家庭照顾者时，模型内的关系如何随受照顾者疾病轨迹的变化而变化。该项目的具体目标是：1)检查护理对象的疾病特征和护理者的心理-行为反应、生物反应和整体身体健康如何随时间变化（从PBMT诊断到诊断后12个月）；在这12个月的时间里，2)研究照顾者的个人特征如何调节照顾者疾病特征与照顾者心理行为反应之间的关系；3)研究照顾者心理行为反应在照顾者疾病特征与照顾者生物反应之间的中介作用；4)研究照顾者的生物反应如何调节其心理行为反应与整体身体健康之间的关系。描述性纵向设计将用于收集数据，以解决项目的目标。线性和逻辑回归分析将用于模拟基线反应。重复测量分析（随机系数模型）将用于检查随时间的变化，潜在增长曲线模型将用于进一步探索纵向数据。该项目与公共卫生的相关性是确定在护理对象疾病轨迹的特定时间点上易受其情绪和身体健康变化影响的护理人员。改善照顾者的情绪和身体健康可以改善照顾的提供和受照顾者的生活质量。

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.