A Positive Psychology Intervention for Allogeneic Stem Cell Transplant Patients.

项目摘要/摘要 异基因干细胞移植是治疗一些血液系统恶性肿瘤的潜在疗法， 它通常需要3-4周的住院治疗。尽管前景看好，但移植过程 康复是密集的，在急性和长期的过程中充满了潜在的危及生命的并发症 恢复。因此，异基因移植的接受者有很高的心理痛苦和生活质量负担。 (QOL)赤字是很常见的。在这一人群中实现最佳心理健康的大多数努力 有针对性地减少痛苦症状(例如抑郁和焦虑)。然而，积极的心理 幸福感(例如，乐观、积极的情绪)可以缓冲这种痛苦，并已被预期地联系在一起 随着同种异体移植患者的生活质量、身体功能和存活率的改善。积极心理学 干预(PPI)，利用系统活动(例如，回忆积极的生活事件，使用个人 优势)，以促进心理健康，持续和持久地增强心理健康 以及医疗环境中的生活质量，但从未用于异基因移植患者。考虑到需要 促进异基因移植后福祉和恢复的新计划，拟议的项目将 在异基因移植受者中开发和测试一种新的PPI，PATH(异体积极心理学 造血干细胞移植)，以满足这一未得到满足的需求。首席研究员Amono博士将 通过文献回顾以及理论框架和测试的应用来开发路径干预 它的可接受性(通过量化参与者评级和离职面谈中的定性反馈)是一种有力的证明- 概念试验(N=10；目标1)。接下来，Amono博士将测试可行性(主要结果)和初步结果 路径干预(使用目标1改进)对儿童心理、功能和行为结果的影响 一项包括70名异基因移植受者的先导性随机对照试验(目标2)。最后，在《目标3》中，天野博士 将对Aim 2试点试验参与者和20名肿瘤学临床医生进行个人半结构化访谈，以 探索在临床环境中实施路径的促进者和障碍。该项目将促进培训 对Amono博士的研究生涯目标至关重要：干预开发、临床试验设计和实施 高级生物统计学和实施科学。天野博士召集了专门的导师，他们是 具有互补专业知识的知名研究人员：医学人群中的PPI试验(主要导师：Jeff 支持肿瘤学干预(共同导师：Areej El-Jwahri，MD)、定量方法(共同 导师：William Pirl，医学博士)，实施科学(共同导师：Elyse Park，博士，公共卫生硕士)和生物统计学 (研究顾问：Brian Healy，博士)Amono博士的指导将得到有组织的课程作业的补充， 研讨会和会议。总而言之，这个K08奖项将为Amono博士成为独立的R01- 资助研究人员和领导者，开发新的循证支持性护理干预措施以改善 异基因移植患者和其他脆弱癌症人群的健康结果。

PROJECT SUMMARY/ABSTRACT Allogeneic stem cell transplantation is a potentially curative treatment for some hematologic malignancies, and it often requires a 3-4-week hospitalization. Notwithstanding the promising nature, the transplantation process and recovery is intensive and fraught with potential life-threatening complications during acute and long-term recovery. Hence, allogeneic transplant recipients have a high burden of psychological distress, and quality of life (QOL) deficits are common. Most efforts to achieve optimal psychological well-being in this population have targeted the reduction of distress symptoms (e.g., depression and anxiety). However, positive psychological well-being (e.g., optimism, positive affect) can buffer against this distress and has been prospectively associated with improved QOL, physical functioning, and survival in allogeneic transplant patients. Positive psychological interventions (PPIs), which utilize systematic activities (e.g., recalling positive life events, using personal strengths) to promote psychological well-being, have consistently and durably enhanced psychological health and QOL in medical settings, but have never been used in allogeneic transplant patients. Given the need for new programs to promote well-being and recovery after allogeneic transplantation, the proposed project will develop and test a novel PPI in allogeneic transplant recipients, PATH (Positive psychology for Allogeneic Transplantation of Hematopoietic stem cells), to fill this unmet need. Principal Investigator Dr. Amonoo will develop the PATH intervention via a review of the literature and application of a theoretical framework and test its acceptability (via quantitative participant ratings and qualitative feedback at exit interviews) in a one-arm proof- of-concept trial (N=10; Aim 1). Next, Dr. Amonoo will test the feasibility (primary outcome) and preliminary efficacy of the PATH intervention (refined using Aim 1) on psychological, functional, and behavioral outcomes in a pilot randomized controlled trial with 70 allogeneic transplant recipients (Aim 2). Finally, in Aim 3, Dr. Amonoo will use individual semi-structured interviews with Aim 2 pilot trial participants and 20 oncology clinicians to explore the facilitators and barriers to implementing PATH in clinical settings. This project will facilitate training essential to Dr. Amonoo’s research career goals: intervention development, clinical trial design and execution, advanced biostatistics, and implementation science. Dr. Amonoo has assembled dedicated mentors who are renowned researchers with complementary expertise: PPI trials in medical populations (primary mentor: Jeff Huffman, MD), supportive oncology interventions (co-mentor: Areej El-Jawahri, MD), quantitative methods (co- mentor: William Pirl, MD), implementation science (co-mentor: Elyse Park, PhD, MPH), and biostatistics (research advisor: Brian Healy, PhD). Dr. Amonoo’s mentorship will be supplemented by structured coursework, seminars, and conferences. In sum, this K08 award will prepare Dr. Amonoo to become an independent R01- funded investigator and leader who develops novel evidence-based supportive care interventions to improve health outcomes for allogeneic transplant patients and other vulnerable cancer populations.