Phone-Based Intimacy Enhancement Intervention for Couples facing Breast Cancer

 描述(申请人提供)：大多数诊断和治疗乳腺癌的女性在确诊后存活了5年，这使得生活质量(QOL)问题变得非常突出。对于许多患有乳腺癌的女性来说，性问题是常见的，也是令人痛苦的，也是生活质量受损的一个主要来源。与乳腺癌治疗后随着时间推移而改善的生活质量的其他方面不同，性担忧往往持续存在，通常不会在没有干预的情况下得到解决。然而，这些担忧在患者的护理中通常被忽视，导致他们得不到充分的诊断和治疗。解决乳腺癌幸存者的性问题可以减少痛苦，支持他们的亲密关系，并促进有效的适应。然而，现有的解决乳腺癌幸存者关于性问题的性生活质量干预措施在内容和形式上都存在局限性。例如，现有的性生活质量干预措施不包括当前的管理建议，而且通常不是一种可以广泛传播的形式。以电话为基础的形式是面对面咨询的一种可行、有效的替代方案，它将增强传播的潜力，是接触长期幸存者的理想选择。此前，PI证明了4次电话亲密增强(IE)干预改善了结直肠癌患者及其伴侣的亲密关系和性行为结果。这一干预措施有望解决乳腺癌幸存者的关切，但还需要做更多的工作来为乳腺癌幸存者量身定做这项干预措施，因为这些人群的性担忧经历、更严重的性发病率的风险因素以及适当的管理方法都不同。这项拟议研究的中心目标是为乳腺癌幸存者量身定做基于电话的IE干预，并在对照试验中进行干预的初步测试。首先，定性焦点小组将确定患者对内容和结构的偏好，这些偏好将被用于根据这一人群的需求量身定做干预措施，随后的认知访谈将确保可理解性。其次，试点试验将检查患者和伴侣的性生活质量和关系结果，以及对患者的心理社会结果(例如，身体形象困扰)的可行性、可接受性和初步疗效。最后，基于限制乳腺癌幸存者参与Intensiv性生活质量干预的障碍的基本原理，一个创新的发展目标将调查选择退出试点试验的符合研究条件的患者候选人的观点。这项发展性调查将确定乳腺癌幸存者的参与障碍和干预偏好，他们选择退出密集试验，以便为未来研究提供不同干预措施的发展。最终，这一研究计划将导致一系列干预措施的良好可用 有能力解决乳腺癌和潜在其他癌症患者的性生活质量未得到充分治疗的领域。

 DESCRIPTION (provided by applicant): The majority of women diagnosed and treated for breast cancer survive 5 years past diagnosis, making quality of life (QOL) concerns highly salient. Sexual concerns are common and distressing for many women with breast cancer and serve as a major source of QOL impairment. Unlike other aspects of QOL that improve over time after breast cancer treatment, sexual concerns often persist and do not typically resolve without intervention. Yet these concerns are typically neglected in patients' care, leaving them underdiagnosed and undertreated. Addressing breast cancer survivors' sexual concerns can reduce distress, support their intimate relationships, and foster effective adjustment. However, existing sexual QOL interventions that address the sexual concerns of breast cancer survivors suffer from limitations in both content and format. For instance, existing sexual QOL interventions do not include current management recommendations and are not generally in a format that can be widely disseminated. A telephone-based format is a viable, effective alternative to in- person counseling that would enhance the potential for dissemination and be ideal for reaching long-term survivors. Previously, the PI demonstrated that demonstrated that a 4-session telephone-based Intimacy Enhancement (IE) intervention improved intimacy and sexual outcomes for colorectal cancer patients and their partners. This intervention holds promise for addressing the concerns of breast cancer survivors, but additional work is needed to tailor this intervention to breast cancer survivors because these populations differ in their experiences of sexual concerns, in the risk factors for worse sexual morbidity, and in appropriate management approaches. The central goal of the proposed research is to tailor the telephone-based IE intervention to breast cancer survivors and conduct a preliminary test of the intervention in a controlled trial. First, qualitative focus groups will identify patient preferencs for content and structure which will be used to tailor the intervention to the needs of this population subsequent cognitive interviews will ensure comprehensibility. Second, the pilot trial will examine the feasibility, acceptability, and preliminary efficacy on patient and partner sexual QOL and relationship outcomes, and on patient psychosocial outcomes (e.g., body image distress). Finally, based on the rationale that barriers exist that limit participation in intensiv sexual QOL interventions for breast cancer survivors, an innovative developmental aim will investigate the perspectives of study-eligible patient candidates who opt out of participating in the pilot trial. This developmental investigation will identify the participation barriers and intervention preferences of breast cancer survivors with sexual concerns who opt out of the intensive trial in order to inform the development of different interventions for future study. Ultimately, this program of research will lead to the availability of a range of interventions well equipped to address the undertreated area of sexual QOL for those with breast and potentially other cancers.