Problem-Solving Therapy for Cancer Caregivers: A Randomized Clinical Trial in Outpatient Palliative Care

从母体中提取 近几十年来，肿瘤治疗的主要环境已从医院住院部转移到 门诊诊所，留下近460万家庭护理人员负责大部分的日常， 在美国提供的时钟癌症护理。癌症的发生往往是在高度紧张的情绪 和社会背景，使照顾者容易受到重大的，可能是长期的，不利的影响。 虽然姑息治疗团队的理想定位，以帮助家庭照顾者科普众多的 虽然他们遇到的压力源，但几乎没有证据可以作为门诊癌症护理人员支持的基础。 姑息治疗诊所为了解决在这种情况下对护理人员干预措施进行研究的迫切需要， 一个跨学科的研究小组将进行一项多地点的随机试验，研究解决问题的治疗方法， 接受门诊姑息治疗的癌症患者的家庭照顾者。潜在的障碍和 还将审查农村和城市诊所采用解决问题疗法的促进者， 从而更好地理解治疗最终将被递送的背景， 要有效率。本研究的具体目的如下：1）确定问题解决疗法对 癌症患者接受门诊姑息治疗的家庭照顾者的心理困扰; 测量问题解决疗法对家庭照顾者的积极方面的影响， 接受门诊姑息治疗的癌症患者;以及3）确定潜在的障碍和促进因素， 在门诊姑息肿瘤治疗中对家庭照顾者采用解决问题的疗法。结束时 在这项研究中，研究人员将广泛传播关于解决问题的有效性的研究结果， 治疗，他们将很好地定位，以促进家庭照顾者的福祉，通过例行和 在门诊姑息性癌症护理中持续提供解决问题的治疗。 摘要补充 这项补充研究将利用正在进行的随机临床试验的现有资源， 为接受门诊姑息治疗的癌症患者家属提供解决问题的疗法 （R 01 CA 258311）以更深入地了解黑人和白色家庭护理人员的社交网络， 他们如何影响家庭照顾者解决问题和做出其他决定。研究 建立在对社交网络在癌症治疗中的作用的大量研究的基础上， 通过混合方法的方法，允许使用经过充分验证的定量 方法和丰富的定性调查。这将使我们的研究团队能够将我们的研究结果与 更广泛的科学文献，同时也创造空间，探索少数群体中常见的家庭结构， 然而，癌症研究人员和临床医生对社区的研究却很少， 一模一样。本研究的具体目的是：1）研究黑人和白色家庭照顾者的感知差异 他们的社交网络，包括家庭成员，朋友和重要的其他人，和2）描述如何黑色 白色家庭照顾者的社交网络影响他们作为照顾者的决策。

Abstract from the Parent In recent decades, the primary setting for oncology treatment has shifted from the hospital inpatient unit to the outpatient clinic, leaving nearly 4.6 million family caregivers responsible for most of the day-to-day, round-the- clock cancer care provided in the United States. Cancer caregiving often occurs in a highly stressful emotional and social context, leaving caregivers vulnerable to significant, potentially long-lasting, adverse effects. Although palliative care teams are ideally positioned to help family caregivers cope with the numerous stressors they encounter, there is little evidence on which to base cancer caregiver support in the outpatient palliative care clinic. To address the pressing need for research on caregiver interventions in this setting, an interdisciplinary team of investigators will conduct a multisite, randomized trial of problem-solving therapy for family caregivers of individuals with cancer who are receiving outpatient palliative care. Potential barriers and facilitators to the adoption of problem-solving therapy in both rural and urban clinics will also be examined, resulting in a greater understanding of the context in which the therapy will ultimately be delivered if shown to be effective. The study’s specific aims are as follows: 1) determine the effect of problem-solving therapy on psychological distress among family caregivers of patients with cancer receiving outpatient palliative care; 2) measure the effect of problem-solving therapy on positive aspects of caregiving among family caregivers of patients with cancer receiving outpatient palliative care; and 3) identify potential barriers and facilitators to the adoption of problem-solving therapy for family caregivers in outpatient palliative oncology. At the conclusion of the study, investigators will broadly disseminate findings regarding the effectiveness of problem-solving therapy, and they will be well positioned to promote family caregiver wellbeing through the routine and sustained delivery of problem-solving therapy in outpatient palliative cancer care. Abstract from Supplement This supplemental research study will leverage existing resources from an ongoing randomized clinical trial of Problem-Solving Therapy for family members of individuals with cancer receiving outpatient palliative care (R01CA258311) to generate a richer understanding of Black and White family caregivers’ social networks and how they influence how family caregivers solve problems and otherwise make caregiving decisions. The study builds on a robust body of research on the role of social networks in cancer caregiving and also strengthens the evidence base via a mixed methods approach that allows for the use of well-validated quantitative measures and rich qualitative inquiry. This will enable our research team to integrate our findings with the broader scientific literature while also creating space to explore family structures that are common in minority communities yet less often studied and more poorly understood among cancer researchers and clinicians alike. The study’s specific aims are to 1) examine differences in Black and White family caregivers’ perceptions of their social networks, inclusive of family members, friends, and significant others, and 2) describe how Black and White family caregivers’ social networks influence how they make decisions as caregivers.