Efficacy of a Mindfulness-Based Stress Management Program for Allogeneic HCT Caregivers
基于正念的压力管理计划对同种异体 HCT 护理人员的功效
基本信息
- 批准号:10096213
- 负责人:
- 金额:$ 56.34万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-04-01 至 2026-03-31
- 项目状态:未结题
- 来源:
- 关键词:AffectAftercareAgeAllogenicAnxietyAttentionBiological MarkersCancer CenterCancer InterventionCancer PatientCaregiver BurdenCaregiver supportCaregiversCaringChild RearingClinic VisitsConflict (Psychology)Continuity of Patient CareDataDiseaseDissemination and ImplementationDistressEmotionalEmotionsEsthesiaFamily CaregiverGenderGrowthHairHealthHematologic NeoplasmsHematopoietic Stem Cell TransplantationHomeHydrocortisoneIncomeInvestigationLengthMalignant NeoplasmsMeasuresMental DepressionMental HealthMindfulness TrainingOutcomeParticipantPatient Self-ReportPatientsPilot ProjectsPlacebosPopulationPosttraumatic growthRandomizedReportingResearchRoleSelf EfficacyStressSymptomsTestingThinkingTimeTransplant RecipientsTransplantationUnited States National Institutes of HealthWorkarmattentional controlbasecancer carecancer transplantationcaregiver interventionscaregivingcurative treatmentsdesigndiariesefficacy evaluationemotion regulationexperiencefollow-uphealth care service utilizationhospital readmissionimprovedmembermindfulnessmindfulness interventionmultidisciplinarynegative affectnovelpost-transplantprimary outcomeprogramspsychosocialresidencesecondary outcomestress managementstressortreatment as usual
项目摘要
PROJECT SUMMARY/ABSTRACT
Caring for an allogeneic hematopoietic stem cell transplant (HCT) patient is a significant responsibility,
involving a commitment to be available 24/7 up to at least 100 days post-transplant to provide emotional and
physical support. Informal family caregivers of HCT patients often experience significant role changes that can
conflict with other responsibilities (e.g., work, child rearing). Caregivers often report high burden and poor
mental health, which can have an adverse impact on patient health outcomes, including increased anxiety,
depression, and decreased patient survival. However, some research suggests that caregivers may benefit
when they receive adequate support and when given the opportunity for growth and meaning-making. Despite
this, few comprehensive and proactive caregiver support programs exist. Mindfulness facilitates the ability to
shift attention to experiences purposefully, with a sense of acceptance (as opposed to trying to change or react
to it). Active mechanisms of mindfulness (e.g., improved attention, emotion regulation, decentering) combined
with the unique circumstances of HCT caregivers, suggest that approaching thoughts/emotions/sensations via
mindfulness may convey benefits above and beyond what is found in other treatment approaches. Our multi-
disciplinary team systematically developed a 6-week mindfulness-based intervention for allogeneic HCT
caregivers – FOCUS (Focusing On mindfulness for Caregivers Under Stress). FOCUS spans the course of
patient treatment, with session 1 occurring prior to transplant, sessions 2-3 taking place immediately following
transplant, and sessions 4-6 occurring post-discharge. Pilot testing revealed that FOCUS was highly feasible
and acceptable for allogeneic HCT caregivers and useful for managing stress. Significant decreases in
negative affect and increases in mindfulness, post traumatic growth, and mental health symptoms were
observed from baseline to end of treatment; findings were maintained through the 1-month follow-up. This
project builds on our pilot study by randomizing caregivers (N=270) to one of three treatment conditions:
FOCUS, Healthy Living (HL), and Usual Care (UC). This three-arm design will allow us to rigorously test if
FOCUS is more efficacious than both HL (attention placebo condition matched to FOCUS on time and contact)
and UC (attention control condition). Self-report assessments will occur at baseline, end of treatment, and 2-
and 6-months post-treatment. Biomarker data will be collected via hair cortisol concentrations, and daily diaries
will assess fluctuating variables (e.g., affect, state mindfulness). We anticipate mindfulness to ultimately reduce
caregiver burden (primary outcome) via measured mechanisms (e.g., reduced stress). We expect patient
distress and healthcare utilization to be both directly and indirectly impacted via caregiver participation in
FOCUS. This proposal aligns with a recent call from NIH to develop and test interventions for cancer
caregivers that also improve patient health outcomes. If ultimately proven efficacious, future research includes
plans for dissemination/implementation, as well as extension to other cancer caregiver populations.
项目总结/摘要
照顾异基因造血干细胞移植(HCT)患者是一项重要的责任,
包括承诺在移植后至少100天内24/7提供情感和
物理支持。HCT患者的非正式家庭照顾者经常经历重大的角色变化,
与其他职责冲突(例如,工作、育儿)。照顾者经常报告高负担和贫穷
心理健康,这可能对患者的健康结果产生不利影响,包括焦虑增加,
抑郁症和患者生存率下降。然而,一些研究表明,
当他们得到足够的支持,当他们有机会成长和创造意义时。尽管
因此,很少有全面和积极主动的照顾者支助方案。正念促进了以下能力
有目的地将注意力转移到体验上,并有一种接受感(而不是试图改变或做出反应
到它)。正念的积极机制(例如,改善注意力、情绪调节、离心)结合
根据HCT护理人员的独特情况,建议通过以下方式处理思想/情感/感觉
正念可以传达超越其他治疗方法的好处。我们的多-
一个学科团队系统地开发了一种为期6周的基于正念的同种异体HCT干预
专注(Focus On mindfulness for Caregivers Under Stress)FOCUS跨越了
患者治疗,第1阶段在移植前进行,第2-3阶段在移植后立即进行
移植,以及在出院后进行的第4-6次治疗。试点测试表明,FOCUS是高度可行的
并且对于同种异体HCT护理者是可接受的,并且对于管理压力是有用的。显著下跌
负面影响和正念的增加,创伤后成长和心理健康症状,
从基线到治疗结束进行观察;结果在1个月的随访中保持不变。这
该项目建立在我们的试点研究的基础上,将护理人员(N=270)随机分配到三种治疗条件之一:
专注、健康生活(HL)和精神护理(UC)。这种三臂设计将使我们能够严格测试,
FOCUS比两种HL更有效(注意安慰剂条件与FOCUS在时间和联系方面匹配)
UC(Attention Control Condition)自我报告评估将在基线、治疗结束和2-
治疗后6个月。将通过头发皮质醇浓度和每日日记收集生物标志物数据
将评估波动变量(例如,影响,状态正念)。我们预计正念最终会减少
通过测量的机制(例如,减少压力)。我们期待耐心
通过护理人员参与,
专心点这项提议与NIH最近呼吁开发和测试癌症干预措施的呼吁一致
护理人员也能改善患者的健康状况。如果最终证明有效,未来的研究包括
传播/实施计划,以及扩展到其他癌症护理人群。
项目成果
期刊论文数量(0)
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科研奖励数量(0)
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专利数量(0)
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{{ truncateString('Christine Vinci', 18)}}的其他基金
Augmented Reality as an Adjunct to Quitline Counseling for Smoking Cessation
增强现实作为戒烟热线咨询的辅助手段
- 批准号:
10375902 - 财政年份:2022
- 资助金额:
$ 56.34万 - 项目类别:
Augmented Reality as an Adjunct to Quitline Counseling for Smoking Cessation
增强现实作为戒烟热线咨询的辅助手段
- 批准号:
10655290 - 财政年份:2022
- 资助金额:
$ 56.34万 - 项目类别:
Efficacy of a Mindfulness-Based Stress Management Program for Allogeneic HCT Caregivers
基于正念的压力管理计划对同种异体 HCT 护理人员的功效
- 批准号:
10378474 - 财政年份:2021
- 资助金额:
$ 56.34万 - 项目类别:
Efficacy of a Mindfulness-Based Stress Management Program for Allogeneic HCT Caregivers
基于正念的压力管理计划对同种异体 HCT 护理人员的功效
- 批准号:
10604286 - 财政年份:2021
- 资助金额:
$ 56.34万 - 项目类别:
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