Prepare to Care, A Supported Self-Management Intervention for Head and Neck Cancer Caregivers

项目摘要 头颈癌（HNC）患者在放疗（RT）期间可能会经历改变生活的副作用， 导致显著的护理需求和心理困扰，超过了患有许多其他疾病的患者， 癌症诊断HNC患者的非正式（无报酬）照顾者的心理健康状况较差 与患者和普通人群相比。HNC护理人员的信息需求和愿望未得到满足 在患者肿瘤治疗期间减轻压力的健康计划;然而，没有发表 旨在满足HNC照顾者的心理教育和压力管理需求的干预研究。 本研究的总体目标是通过实施一项 支持自我管理（SSM）干预，准备护理，以减少负面心理影响 与在患者RT期间提供护理相关。接受RT的患者的20名HNC护理人员将 在患者RT期间参与SSM干预并完成评估（负担、心理 痛苦、生活质量和自我效能（a）应对癌症和（B）缩短进行性肌肉 放松）干预前后和干预后的半结构化访谈。准备护理 包括自我指导的教育材料，以提供信息和教授管理情绪的策略 促进健康的行为。材料以硬拷贝和在线形式提供，iPad与研究链接 在每日RT治疗期间在诊所提供网站。提供了几个主题（或模块）， 通过每周与干预人员进行评估来支持模块的选择， 需求对于目标1，我们将评估SSM的可行性（应计、参与、保留）和可接受性 为非正规照顾者设计的心理教育和压力管理技能建设干预措施 （n=20）接受RT的HNC患者。对于目标2，我们将获得有关护理人员中间 （（a）应对癌症和（B）简化渐进性肌肉放松的自我效能）和结局 干预前后的变量（负担、心理困扰和生活质量）。目标3： 将通过审查以下内容完善干预程序和材料，供今后的研究使用：a）来自 护理人员和干预人员的记录，以及B）关于模块利用的定量数据。结果将提供 为HNC照顾者制定的第一次心理社会干预的可行性和可接受性数据， 患者RT，并将直接告知将实施的多中心随机对照试验的开发 通过维克森林NCI社区肿瘤学研究计划（NCORP）研究基地。

PROJECT SUMMARY Patients with head and neck cancer (HNC) can experience life altering side effects during radiotherapy (RT), resulting in significant care needs and psychological distress that exceeds that of patients with many other cancer diagnoses. Informal (unpaid) caregivers of patients with HNC have poorer psychological health compared to patients and the general population. HNC caregivers have unmet informational needs and desire wellness programs on stress reduction during patient oncologic treatment; however, there are no published intervention studies designed to meet HNC caregivers’ psycho-educational and stress management needs. The overall goal of this research is to optimize stress management skills in HNC caregivers by implementing a supported self-management (SSM) intervention, Prepare to Care, to reduce negative psychological effects associated with providing care during patient RT. Twenty HNC caregivers of patients undergoing RT will participate in the SSM intervention during the patient’s RT and complete assessments (burden, psychological distress, quality of life, and self-efficacy for (a) coping with cancer and (b) abbreviated progressive muscle relaxation) pre and post- intervention and semi-structured interviews post-intervention. Prepare to Care includes self-directed educational materials to provide information and teach strategies to manage emotions and promote healthy behaviors. Materials are provided in hard copy and online, with iPads linked to the study website available at the clinic during daily RT treatments. Several topics (or, modules) are offered and selection of modules is supported by weekly assessments with the interventionist to identify caregivers’ current needs. For Aim 1, we will assess feasibility (accrual, participation, retention) and acceptability of a SSM intervention for psycho-education and stress management skills building designed for informal caregivers (n=20) of HNC patients undergoing RT. For Aim 2, we will obtain preliminary data on caregiver intermediate (self-efficacy for (a) coping with cancer and (b) abbreviated progressive muscle relaxation) and outcome variables (burden, psychological distress, and quality of life) before and after the intervention. For Aim 3, we will refine intervention procedures and materials for future studies by examining: a) qualitative data from caregivers and interventionist notes and b) quantitative data regarding module utilization. Results will provide feasibility and acceptability data on the first psychosocial intervention developed for HNC caregivers during patient RT and will directly inform the development of a multisite randomized controlled trial to be implemented through the Wake Forest NCI Community Oncology Research Program (NCORP) Research Base.