Couples and Cancer: Building Partner Efficacy in Caring

描述(由申请人提供)：目前的估计是，三分之一的美国人--也就是三分之二的夫妇--可能会面临癌症的经历。这项第一阶段的SBIR建议是为了测试提高癌症患者伴侣提供的护理效果的可行性。合作伙伴将接受精选的补充治疗技术方面的培训，这些技术有望改善癌症的生活质量和福祉。结果将在三个月内进行评估。目的1：确定干预对个体评估的患者及其亲密伴侣的情绪调节、功能生活质量和关系质量的纵向影响。目标2：将样本分成不同的小组，以确定预测谁最有可能得到干预，谁最不可能得到帮助的标志物。目标3：确定干预中教授的照料技术的使用障碍和促进者。上述目标的实现将支持对以下假设的检验：假设1：与对照阶段相比，患者和伴侣在干预阶段的情绪调整、功能生活质量和关系质量方面都将有显著改善。假设2：伴侣使用干预技术的频率将预测患者和伴侣的情绪调整水平、功能生活质量和关系质量。样本：48对夫妇，癌症类型、分期和病程混合。方法：我们将使用纵向、受试者内部、控制和干预阶段的设计，使用统计方法提供传统方法所不能提供的对数据的洞察(单病例纵向数据的N-of-1“预处理”；在将单个受试者合并到复合组之前对数据进行筛选，以评估和避免矛盾混淆；以及分级最优分类树分析，以提供关于结果变量的样本分层，以实现理论上的最大准确性和简洁性)。焦点小组将提供关于利用障碍和促进者的定性数据，干预的现象学，以及对未来改进的批评。长期目标：根据研究结果，第二阶段研究将开发和测试多媒体培训方法。我们的目标是一系列教育，是以证据为基础的，鼓舞人心的，并能接触到面临癌症的夫妇的大众市场。

DESCRIPTION (provided by applicant): Current estimates are that one in three Americans - and therefore two in three couples - are likely to face the experience of cancer. This Phase I SBIR proposal is to test the feasibility of improving the efficacy of caregiving provided by the partners of cancer patients. Partners will be trained in selected complementary therapy techniques that show promise for improving quality of life and well-being in cancer. Outcomes will be evaluated over three months. Aim 1: Determine the longitudinal within-subject effects of the intervention on emotional adjustment, functional quality of life, and quality of relationship in a sample of patients and their intimate partners, assessed as individuals. Aim 2: Stratify the sample into subgroups to identify markers predicting who is most likely and who is least likely to be helped by the intervention. Aim 3: Identify barriers and facilitators of utilization of the caregiving techniques taught in the intervention. Achieving the above aims will support testing of the following hypotheses: Hypothesis 1: There will be significant improvements in emotional adjustment, functional quality of life, and quality of relationship during the intervention phase compared to the control phase, for both patients and partners. Hypothesis 2: The partner's frequency of use of the intervention techniques will predict levels of emotional adjustment, functional quality of life, and quality of relationship in both the patient and the partner. Sample: 48 couples, mixed types, stages and durations of cancer. Method: We will use a longitudinal, within-subjects, control and intervention phases design employing statistical methodologies that provide insights into the data that are not afforded by traditional methods (N-of-1 "pre-processing" of single-case longitudinal data; screening the data prior to combining individual subjects into composite groups to assess and circumvent paradoxical confounding; and hierarchically optimal classification tree analysis to provide sample stratification in regard to outcome variables for theoretical maximum accuracy and parsimony). Focus groups will provide qualitative data on barriers and facilitators of utilization, phenomenology of the intervention, and critique for future refinement. Long-term goal: Based on the findings, a Phase II study would develop and test a multimedia approach to the training. The goal is an educational series that is evidence-based, inspirational, and accessible to the mass market of couples facing cancer.