Caregivers of Cancer Pain Patients: Coping Intervention

在美国，四分之三的家庭将至少有一名家庭成员被诊断出患有癌症。在 这些家庭中的大多数，一个或多个成员将负责为癌症患者提供护理。最高可达50- 其中80%的患者会有严重的疼痛，大多数患者没有得到适当的治疗。重要力量，如 由诊断相关团体创建的医院外运动和管理性医疗的重要力量 创造了一种现实，在这种情况下，家庭和患者发现自己在家中提供非常复杂的护理 可能不是他们的偏好。由于存在未缓解的疼痛，提供这种护理变得更加困难。这个 现实是，客厅已经成为重症监护室，成为家庭照顾者筋疲力尽的地方 背负着沉重的负担。家庭照顾者，他们对药理学、药物剂量和 评估或治疗疼痛被要求成为全天候护理提供者。对照顾问题的关注 重要的是要了解我们医疗保健系统的这一主要的、无偿的部分是如何运作的，以及我们可以做些什么 把照顾的压力降到最低。针对癌症疼痛患者的家庭照顾者的研究是 有限的。许多前瞻性的研究都集中在癌症疼痛患者身上，很少有结果测量包括在 照顾者。大多数研究表明，送礼者会增加情绪上的痛苦。照顾儿童的影响 癌症患者疼痛对家庭成员生活质量的影响仍不清楚，因为有效的照顾者特定的生活质量 仪器还没有使用过。限制研究进展的另一个因素是缺乏经过经验验证的 了解癌症患者生活质量个体差异或改善其生活质量的概念模型 有疼痛的病人。拟议的研究计划旨在增加对癌症患者护理的了解 通过使用有效的、照顾者特定的生活质量工具和经验验证的压力过程模型，可以获得与疼痛相关的信息。vbl.使用 护理、心理教育和应对技能干预的压力过程模型将使用 随机对照设计。护理者/患者(n=300)将被随机分配到标准护理或 标准护理加上应对技能干预。护理员将参加每周六次为期一小时的探视，内容包括 关于疼痛评估、止痛药、副作用、情绪困扰识别的教学信息 耐心、压力管理、与疼痛团队的沟通，以及围绕这些主题的角色扮演场景。 将测试干预的有效性，并确定潜在的调解人和主持人 干预措施的有效性。

Three out of four families in the United States will have at least one family member diagnosed with cancer. In the majority of these families, one or more members will be responsible for providing care to the cancer patient. Up to 50- 80% of these patients will have significant pain, the majority not receiving adequate treatment. Important forces such as the movement out of the hospital created by diagnosis-related groups and the significant force of managed care have created a reality in which families and patients are finding themselves at home providing very complex care when that may not be their preference. The provision of this care is made more difficult by the presence of unrelieved pain. The reality is that the living room has become the intensive care unit and the place where family caregivers are exhausted and burdened. Family caregivers who have very little information about pharmacology, dosing of medications, and assessing or treating pain are asked to become around-the-clock care providers. Attention to caregiving issues is important in order to understand how this major, unpaid segment of our health care system works and what we can do to minimize the stress of caregiving. Research focusing on the family caregiver of the cancer patient with pain is limited. Much deseriptive work has focused on the cancer patient with pain, with few outcome measures included for the caregiver. Most work suggests that earegivers have increased emotional distress. The impact of caregiving for cancer patients with pain on family members' quality of life (QOL) remains unclear since valid caregiver-specific QOL instruments have not been used. Another factor limiting research progress is the lack of an empirically validated conceptual model for understanding individual differences in QOL or improving QOL among earegivers of cancer patients with pain. The proposed program of research seeks to increase knowledge about caregiving for cancer patients with pain by using a valid, caregiver-specific QOL instrument and an empirically validated stress process model. Using the stress process model for caregiving, a psychoeducation and coping skills intervention will be evaluated using a randomized, controlled design. Caregiver/patient dyads (n = 300) will be randomly assigned to standard care or standard care plus the coping skills intervention. The caregiver will attend six weekly one-hour visits containing didactic information regarding pain assessment, pain medications, side effects, recognition of emotional distress in the patient, stress management, and communication with the pain team as well as role play scenarios around these themes. The effectiveness of the intervention will be tested as well as identification of potential mediators and moderators of the effectiveness of the intervention.