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

项目摘要/摘要 患有癌症的年轻人在与健康相关的疾病中经历更多的情绪困扰和更大的障碍 生活质量(HRQOL)高于老年患者。青春期的癌症诊断干扰了参与 在正常的发展任务中，如接受高等教育，开始职业生涯，建立经济 独立，发展浪漫的伙伴关系。这一正常活动的中断，加上 不熟悉和具有挑战性的癌症治疗要求会导致情绪困扰和降低HRQOL。 迫切需要制定、测试和实施循证干预措施，以支持 这些年轻人可能正在经历他们一生中最具挑战性和最令人衰弱的时期。 目前的心理社会护理没有充分解决年轻人的独特关切。一个最优的 解决方案将为年轻人提供应对各种和众多压力来源的技能，解决不发达问题 解决问题的能力是这个年龄段的特点，并且在学习和使用期间都比较简单 被诊断出癌症后的紧张时刻。为了解决这些临床护理差距，该项目将评估 专门为年轻人开发的解决问题技能培训干预的有效性 问题解决疗法的核心原则。《Bright Ideas-青年成人》(Bright Ideas-YA)取材于 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 减少儿科病人照顾者情绪困扰的计划。好主意-YA是一个6节课，一节课- 一对一面对面干预，传授患者克服个人挑战的系统方法 跨越任何生命领域。它旨在提高患者在面临重大压力时解决问题的能力 比如癌症。在前期工作中，患有癌症的年轻人发现了好主意-YA可接受、相关和 很有用。接受Bright Ideas-YA的患者在解决问题的能力和减少问题的能力方面显示出改善 抑郁和焦虑的症状。在建议的项目中，我们将进行多点随机 Bright Ideas-YA与强化常规心理社会护理对300名YA患者的对照试验(年龄) 18-39岁)接受癌症治疗。我们将评估疗效，并检查调解人和主持人 使用基线、干预后(3个月)和随访(6个月和12个月)评估的干预效果 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改善 技能，较低的痛苦(即抑郁和焦虑)，以及与增强的平时相比更好的HRQOL 心理社会护理。这项拟议的研究与国家癌症研究所的癌症控制和 人口科学使命：减轻癌症负担，提高患者和 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.