Cancer Caregivers and Their Struggle(s) between Work and Family

癌症护理人员及其在工作和家庭之间的挣扎

• 批准号: 10116570
• 负责人: Cathy J Bradley
• 金额: $ 1.49万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10116570
• 关键词: Absenteeism; Address; Adherence; Adjuvant; Affect; Age; American; Anxiety; Biological Markers; Breast Cancer Treatment; Cancer Intervention; Cancer Patient; Caregiver Burden; Caregiver well-being; Caregivers; Caring; Chronic stress; Colorectal Cancer; Computerized Medical Record; Data; Depressed mood; Disabled Persons; Disease; Distress; Emotional; Employment; Ensure; Equipment and supply inventories; Family; Family Caregiver; Functional disorder; Generations; Hair; Health; Health Insurance; Health Services; Hospitalization; Hour; Hydrocortisone; Inequality; Inflammation; Intervention; Job Satisfaction; Laboratories; Length; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Medical; Mental Depression; Modality; Morbidity - disease rate; Online Systems; Outcome; Outpatients; Participant; Patient Self-Report; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pharmacy facility; Physicians; Physiological; Psychosocial Stress; Randomized; Regulation; Relaxation; Respiration; Risk; Role; Services; Source; Spouses; Stem cell transplant; Stress; Symptoms; System; Telomerase; Testing; Time; Transplant Recipients; Visit; Work; allostatic load; anxious; base; cancer therapy; caregiver interventions; caregiving; comparison intervention; depressive symptoms; emotional distress; evidence base; experience; flexibility; follow-up; health care service utilization; improved; income insurance; loved ones; meetings; mortality; perceived stress; primary caregiver; primary outcome; programs; psychoeducation; psychologic; psychological distress; psychological outcomes; response; secondary outcome; stress management; survivorship; symptom management; symptomatic improvement; telomere; treatment as usual

This application is in response to FOA “Intervening with cancer caregivers to improve patient health outcomes and optimize heath care utilization” (PAR-16-317) in which we specifically address employed caregivers (CG) and their spousal or partnered cancer patient. Sixty-six million Americans cared for a disabled or ill person in 2015 while CGs of cancer patients represented about 17% of all CGs. Cancer CGs are more distressed than CGs of other medical disorders. Minimal availability of supportive interventions for CGs who care for those with cancer during treatment and afterwards represents an important service disparity. Furthermore, employed cancer CGs must manage multiple responsibilities (the so-called “sandwich generation”) while still caring for their loved-one. Continued employment of the CG may be required for CGs to provide a source of income and/or health insurance for the family. Interventions specifically addressing stress management for cancer CGs have not incorporated unique needs of employed CGs, tracked CG's healthcare utilization as well as emotional and physiological wellbeing. We will test the influence(s) of an evidence-based psychosocial stress management intervention enhanced for employed CGs preselected for greater distress compared to treatment as usual (TAU) on their depression (the CG primary outcome), CG healthcare utilization, and biomarkers of chronic stress. We will allow CGs to select as desired to reduce CG burden from three effective modalities (one-on-one, video chat, or web-based) similar in content as their stress management intervention. This approach allows greater flexibility for the CG to participate in the intervention and thus improve adherence. We will test the extent to which the CG's participation in the intervention compared to TAU also influences the patient's symptom management, distress, and patient healthcare utilization. Emotional distress will be measured using reliable self-reports of psychological depression, anxiety, and stress for both the CG and the patient. Healthcare utilization will use both self-report alongside an available electronic system, COMPASS. COMPASS includes pharmacy use, laboratory results, physician encounters, hospitalizations, and other information also in the electronic medical record. This study will fill an important gap in our understanding of an intervention enhanced for working CGs on improved health outcomes both for themselves as well as for their patient compared to TAU.

此应用程序是为了响应FOA“干预癌症护理人员以改善患者健康” 结果和优化卫生保健利用”（PAR-16-317），其中我们专门解决就业 照顾者（CG）和他们的配偶或合作伙伴的癌症患者。6600万美国人照顾残疾人 2015年，癌症患者的CG占所有CG的17%。癌症CG更多 比其他医学疾病的CG更痛苦。对符合以下条件的CG的支持性干预措施的可用性最低 对癌症患者在治疗期间和之后的护理是一个重要的服务差距。 此外，受雇的癌症CG必须管理多个职责（所谓的“三明治 ”（《孝经》）又称“孝经”。对于CG，可能需要继续雇用CG， 为家庭提供收入来源和/或健康保险。专门针对压力的干预措施 癌症CG的管理没有纳入雇用CG的独特需求，跟踪CG的医疗保健 利用以及情感和生理健康。我们将测试基于证据的 加强心理社会压力管理干预措施为预选为更大的痛苦的就业CG 与常规治疗（TAU）相比，其抑郁症（CG主要结局），CG医疗保健 利用和慢性压力的生物标志物。我们将允许CG根据需要进行选择， 三种有效的方式（一对一，视频聊天或基于网络）在内容上类似于他们的压力 管理干预。这种方法使协商小组能够更灵活地参与干预 从而提高粘附性。我们将测试CG参与干预的程度 与TAU相比， 利用率情绪困扰将使用可靠的心理抑郁，焦虑， 以及CG和患者的压力。医疗保健利用率将同时使用自我报告和 可用的电子系统，罗盘。COMPASS包括药房使用、实验室结果、医生 就诊、住院和其他信息也在电子医疗记录中。这项研究将填补一个 在我们对加强工作CG改善健康结果的干预措施的理解方面存在重要差距 既为自己，也为自己的病人。