Brief Behavioral Intervention for Dyspnea in Patients with Advanced Lung Cancer

晚期肺癌患者呼吸困难的简短行为干预

基本信息

  • 批准号:
    10078875
  • 负责人:
  • 金额:
    $ 49.97万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2017
  • 资助国家:
    美国
  • 起止时间:
    2017-01-19 至 2022-12-31
  • 项目状态:
    已结题

项目摘要

Project Summary Background: Dyspnea is a common and debilitating symptom of advanced lung cancer, with approximately 50% of patients reporting marked breathlessness. Dyspnea is associated with impaired quality of life, decreased participation in social activities, symptoms of depression and anxiety, and even desire for death in patients with lung cancer. Unfortunately, limited data support efficacious treatments for dyspnea. Our multidisciplinary team recently conducted a pilot study examining the delivery of a brief, two-session behavioral intervention for dyspnea management in patients with advanced lung cancer. Trained nurse practitioners administered the intervention to patients in the infusion clinic to facilitate greater access and participation. We observed statistically and clinically significant effects on patient-reported breathlessness, quality of life, and depression symptoms, as well as high patient satisfaction with the intervention components and delivery. Study Aims: For the proposed project, we seek to build on our prior positive findings by conducting a randomized controlled trial (RCT) of the intervention in a larger sample of patients with advanced lung cancers. We will first train oncology nurses to deliver the brief behavioral intervention for dyspnea management, again at the point of care within the infusion clinic as this approach was central to the feasibility and acceptability of the intervention in our pilot study. The specific aims of this study are to demonstrate the efficacy of the brief behavioral intervention for improving self-reported dyspnea (primary outcome) as well as quality of life, mood, and activity level (secondary outcomes) in patients with advanced lung cancer. Study Design & Methods: We will enroll and randomly assign up to 200 patients diagnosed with advanced lung cancer (100 per study group) to receive either the brief behavioral intervention for dyspnea or usual care. The trial will take place at the Massachusetts General Hospital Cancer Center and the Dana-Farber Cancer Institute. Oncology nurses will deliver two, 45 minute interventions sessions for each participant within the infusion clinic. All participants will complete measures of dyspnea, quality of life, anxiety and depression symptoms, as well as activity level at baseline after completion of the intervention phase at 8, 16, and 24 weeks. Conclusions: Other than opioid medications, which offer little clinical benefit, data are lacking to support the efficacy of treatments for dyspnea, a highly impairing symptom in patients with advanced lung cancer. We plan to train oncology nurses in delivering a dyspnea management intervention that incorporates behavioral techniques shown to be effective for improving breathlessness and reducing stress in patients with cancer. By training medical clinicians to administer the behavioral intervention in the oncology care setting, we hope to maximize broad dissemination and patient access to essential symptom management. Data from this R01 will ultimately serve as the basis to apply for funding for a large-scale, multisite effectiveness and dissemination study of the intervention.
项目摘要 背景:呼吸困难是晚期肺癌的常见症状, 50%的患者报告明显呼吸困难。呼吸困难与生活质量受损有关, 减少参与社会活动,抑郁和焦虑的症状,甚至死亡的愿望, 肺癌患者。不幸的是,支持呼吸困难有效治疗的数据有限。我们 一个多学科的团队最近进行了一项试点研究,检查一个简短的,两个会话的行为 晚期肺癌患者呼吸困难干预治疗受过培训的执业护士 在输液门诊对患者进行干预,以促进更多的访问和参与。我们 观察到对患者报告的呼吸困难、生活质量和 抑郁症状,以及患者对干预组件和交付的高度满意度。 研究目的:就建议的项目,我们会在以往研究的正面结果基础上, 在更大样本的晚期肺癌患者中进行干预的随机对照试验(RCT)。 我们将首先培训肿瘤科护士提供呼吸困难管理的简短行为干预, 在输液诊所内的护理点,因为这种方法是可行性和可接受性的核心 在我们的试点研究中进行干预。本研究的具体目的是证明简短的有效性 行为干预改善自我报告的呼吸困难(主要结局)以及生活质量,情绪, 和活动水平(次要结局)。研究设计和方法:我们 将入组并随机分配最多200例诊断为晚期肺癌的患者(每个研究组100例) 接受呼吸困难的短暂行为干预或常规护理。审判将在 马萨诸塞州总医院癌症中心和达纳法伯癌症研究所。肿瘤科护士将 在输液诊所内为每位参与者提供两次45分钟的干预会议。所有参与者将 呼吸困难、生活质量、焦虑和抑郁症状以及活动水平的完整测量, 在第8、16和24周完成干预阶段后的基线。结论:除阿片类药物外 药物,提供很少的临床益处,缺乏数据来支持治疗呼吸困难的疗效, 晚期肺癌患者的一种高度损害性症状。我们计划培训肿瘤科护士, 提供一种呼吸困难管理干预,该干预结合了被证明有效的行为技术 用于改善癌症患者的呼吸困难和减轻压力。通过培训临床医生, 在肿瘤护理环境中进行行为干预,我们希望最大限度地广泛传播 以及患者获得基本症状管理的途径。R01的数据最终将作为 申请资助,对干预措施进行大规模、多地点的有效性和传播研究。

项目成果

期刊论文数量(1)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

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Joseph Andrew Greer其他文献

Joseph Andrew Greer的其他文献

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{{ truncateString('Joseph Andrew Greer', 18)}}的其他基金

Academic Career Skills for Junior Faculty Researchers
初级教师研究人员的学术职业技能
  • 批准号:
    10375476
  • 财政年份:
    2020
  • 资助金额:
    $ 49.97万
  • 项目类别:
Advanced Workshop on Research Skills in Oncology
肿瘤学研究技能高级研讨会
  • 批准号:
    10709205
  • 财政年份:
    2020
  • 资助金额:
    $ 49.97万
  • 项目类别:
Brief Behavioral Intervention for Dyspnea in Patients with Advanced Lung Cancer
晚期肺癌患者呼吸困难的简短行为干预
  • 批准号:
    9216504
  • 财政年份:
    2017
  • 资助金额:
    $ 49.97万
  • 项目类别:
A Web-Based Module for Asthma Management in Primary Care
基于网络的初级保健哮喘管理模块
  • 批准号:
    7801468
  • 财政年份:
    2010
  • 资助金额:
    $ 49.97万
  • 项目类别:
Brief CBT for Anxiety and Advanced NSCLC
针对焦虑和晚期 NSCLC 的简短 CBT
  • 批准号:
    7280213
  • 财政年份:
    2007
  • 资助金额:
    $ 49.97万
  • 项目类别:
Brief CBT for Anxiety and Advanced NSCLC
针对焦虑和晚期 NSCLC 的简短 CBT
  • 批准号:
    7406760
  • 财政年份:
    2007
  • 资助金额:
    $ 49.97万
  • 项目类别:
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