Emotional Expression and Cancer Caregivers

描述（由申请人提供）：这份两次修订的提案是对PA-04-034《癌症控制行为研究探索性赠款》的回应，重点关注造血干细胞移植幸存者的配偶照顾者（CG）-与正常人及其患者同行相比，已知报告痛苦水平升高的人。具体目标是：（1）通过实验操作确定造血干细胞移植患者的CG是否参与保护性缓冲，这是一种应对机制，伴侣借此保护患者免受与疾病相关的担忧或担忧，（2）检查配偶CG之间的情感的主观、表达和生物指标之间的同步性或缺乏同步性，（3）测试情绪表达（EE）练习的可行性和实施，该练习旨在增强配偶CG的心理和免疫功能。本研究将招募117例患者/配偶配对。患者和CG将在患者出院后4-6天完成基线评估（问卷）; CG将提供血液样本以分析TNF-α和IL-6。然后将CG随机分配到三种条件之一：患者存在的EE，患者不存在的EE或对照条件。对于后者，CG将谈论积极的经验和时间管理。对于所有会议，CG将连续3天进行10分钟的谈话，记录口头和非口头表达，并收集同步皮肤电反应。随访评估将在第三次EE会议（问卷调查）后立即进行，并在两个月内再次进行（问卷调查和CG抽血）。这一R21作为方法和措施的可行性/社会实验室测试，在最需要的时候对社区团体进行干预。这些协商小组缺乏资源。研究结果将确定CG是否受益于单独和/或在患者面前表达情感的机会。如果，正如假设的那样，CG受益于在患者缺席的情况下表达的机会，未来的研究可以测试这些机会的方法：书面，口头，面对面或互联网。如果CG受益于在患者面前表达的机会，则可能需要进行二元干预。简而言之，这项研究的结果可以作为未来研究调查和最终临床干预的跳板。

DESCRIPTION (provided by applicant): This twice revised proposal, in response to PA-04-034, Exploratory Grants for Behavioral Research in Cancer Control, focuses on spousal caregivers (CGs) of hematopoietic stem cell transplant survivors - persons known to report elevated levels of distress as compared to both norms and their patient counterparts. Specific Aims are to: (1) Determine, via experimental manipulation, whether or not CGs of hematopoietic stem cell transplant patients engage in protective buffering, a coping mechanism whereby partners shield patients from illness-related concerns or worries, (2) Examine synchrony or lack thereof, desynchrony, among subjective, expressive and biologic indicators of emotion among spousal CGs, and (3) Test the feasibility and implementation of an emotional expression (EE) exercise designed to enhance psychological and immune functioning among spousal CGs. One-hundred and seventeen patient/ spouse dyads will be recruited for the study. Patients and CGs will complete baseline assessments (questionnaires) 4-6 days after the patient's discharge from the hospital; CGs will provide blood samples to analyze TNF- alpha and IL-6. CGs will then be randomly assigned to one of three conditions: EE with the patient present, EE with the patient absent, or a control condition. For the latter, CGs will talk about positive experiences and time management. For all sessions, CGs will talk for 10 minutes on 3 consecutive days, with verbal and nonverbal expressions recorded and concurrent galvanic skin response collected. Follow-up assessments will occur immediately following the third EE session (questionnaires) and again in two months (questionnaires and CG blood draw). This R21 serves as a feasibility/ social laboratory test of methods and measures, intervening with CGs at their greatest time of need. There exists a lack of resources for these CGs. Findings will determine whether CGs benefit from an opportunity to express their emotions, alone and/or in the presence of their patient. If, as hypothesized, CGs benefit from the opportunity to express in the absence of their patient, future research can test methods for such opportunities: written, verbal, face-to-face or internet. If CGs benefit from the opportunity to express in the presence of their patient, dyadic interventions may be warranted. In short, findings from this study can serve as a springboard for future research investigations and, ultimately, clinical interventions.