Bright IDEAS-Young Adults: Problem-Solving Skills Training to Reduce Distress among Young Adults with Cancer

项目概要/摘要 患有癌症的年轻人经历更多的情绪困扰和更大的健康相关损害。 生活质量（HRQOL）高于老年患者。青年期癌症诊断干扰参与 在正常的发展任务，如获得高等教育，开始职业生涯，建立财务 独立和发展浪漫的伙伴关系。这种正常活动的中断， 不熟悉和具有挑战性的癌症治疗需求导致情绪困扰和HRQOL降低。 迫切需要制定、测试和实施循证干预措施， 这些年轻的成年人，因为他们航行也许是最具挑战性和衰弱的时期，他们的生活。 目前的心理社会护理没有充分解决年轻人的独特问题。最佳 解决方案将使年轻人具备应对各种各样的压力源的技能， 解决问题的能力是这个年龄段的特点，并且在学习和使用过程中相对简单， 癌症诊断后的紧张时期。为了解决这些临床护理差距，本项目将评估 解决问题技能培训干预措施的有效性，专门为年轻人开发，并以 解决问题疗法的核心原则“光明的想法-年轻的成年人”（光明的想法-YA）借鉴和 显著扩展了先前的研究，证明了认知行为解决问题技能训练的有效性。 减少儿科病人护理者情绪困扰的计划。明亮的IDEAS-YA是一个6届会议，一个- 一对一面对面的干预，教会患者一种系统的方法来克服个人挑战 任何生命领域。旨在提升病人面对重大压力时解决问题的能力 例如癌症。在初步工作中，患有癌症的年轻人发现Bright IDEAS-YA是可接受的，相关的， 有用的.接受Bright IDEAS-YA的患者在解决问题的能力和减少 抑郁和焦虑的症状在拟定的项目中，我们将进行多中心随机 Bright IDEAS-YA与加强常规心理社会护理的对照试验，纳入300例YA患者（年龄 18-39岁）接受癌症治疗。我们将评估疗效，并检查中介和主持人， 使用基线、干预后（3个月）和随访（6和12个月）评估干预效果 月）。我们假设接受Bright IDEAS-YA的年轻人会报告解决问题的能力有所提高 技能，较低的痛苦（即，抑郁和焦虑），HRQOL较增强的常规 心理社会护理。这项拟议中的研究与国家癌症研究所癌症控制部保持一致， 人口科学的使命是减轻癌症负担，提高患者的生活质量， 幸存者，特别是年轻人等弱势群体。

Project Summary/Abstract Young adults with cancer experience more emotional distress and greater impairments in health-related quality of life (HRQOL) than older patients. Cancer diagnosis during young adulthood interferes with participation in normal developmental tasks such as obtaining higher education, starting a career, establishing financial independence, and developing romantic partnerships. This disruption in normal activities coupled with the unfamiliar and challenging demands of cancer treatment results in emotional distress and reduced HRQOL. There is an urgent and critical need to develop, test, and implement evidence-based interventions to support these young adults as they navigate perhaps the most challenging and debilitating period of their lives. Current psychosocial care does not adequately address the unique concerns of young adults. An optimal solution would give young adults the skills to deal with diverse and numerous stressors, address underdeveloped problem-solving ability characteristic of this age group, and be relatively simple to learn and use during the highly stressful time following a diagnosis of cancer. To address these clinical care gaps, this project will evaluate the efficacy of a problem-solving skills training intervention developed specifically for young adults and grounded in the core tenets of problem-solving therapy. “Bright IDEAS-Young Adults” (Bright IDEAS-YA) draws upon and notably extends prior research demonstrating the efficacy of a cognitive-behavioral problem-solving skills training program for reducing emotional distress in caregivers of pediatric patients. Bright IDEAS-YA is a 6-session, one- on-one face-to-face intervention that teaches patients a systematic approach to overcome personal challenges across any life domain. It aims to enhance patients’ problem-solving ability in the face of significant stressors such as cancer. In preliminary work, young adults with cancer found Bright IDEAS-YA acceptable, relevant, and useful. Patients who received Bright IDEAS-YA showed improvements in problem-solving ability and reductions in symptoms of depression and anxiety. In the proposed project, we will conduct a multi-site randomized controlled trial of Bright IDEAS-YA compared with enhanced usual psychosocial care with 300 YA patients (ages 18-39 years) undergoing cancer treatment. We will evaluate efficacy and examine mediators and moderators of intervention effects using assessments at baseline, post-intervention (3 months), and follow-up (6 and 12 months). We hypothesize that young adults who receive Bright IDEAS-YA will report improved problem-solving skills, lower distress (i.e., depression and anxiety), and better HRQOL compared with enhanced usual psychosocial care. The proposed study aligns with the National Cancer Institute’s Division of Cancer Control and Population Sciences mission to reduce the burden of cancer and enhance the quality of life of patients and survivors, particularly among vulnerable groups such as young adults.