Brief CBT for Anxiety and Advanced NSCLC

描述(申请人提供)：标题：用于焦虑和晚期NSCLC的简要CBT项目摘要/摘要概述：这是一种开发和初步测试认知行为疗法(CBT)的应用，用于治疗晚期非小细胞肺癌(NSCLC)患者的焦虑。总体目标是为这种治疗的全面随机对照试验奠定必要的基础。背景：焦虑症的CBT是一种基于证据的、有效的心理社会干预措施，它还没有在一般或晚期肺癌的肿瘤科患者中被检测过。肺癌是美国第二常见的癌症，也是导致死亡的主要原因之一。应对这种诊断可能会引起临床上显著的、痛苦的和干扰性的焦虑，并与生活质量下降和更糟糕的医疗结果相关。研究计划：这项研究将遵循美国国立卫生研究院定义的行为疗法开发指南。因此，将分两个阶段进行。第一阶段是将最先进的CBT用于治疗焦虑，以适应特定人群的晚期非小细胞肺癌患者。这将包括进行定性访谈，以获得晚期肺癌患者对CBT治疗焦虑成分的反馈，制定治疗手册的大纲，并公开进行干预。第二阶段是遵循治疗手册大纲的心理社会干预的先导性随机对照试验，以检查患者的可接受性、分娩的可行性，以及对减轻焦虑和改善生活质量的效果大小的估计。环境：这项研究将在马萨诸塞州总医院进行，利用癌症护理中心(胸科肿瘤学服务)和精神病学部行为医学服务的临床和研究专业知识，后者在认知行为疗法开发和测试方面拥有相当大的专业知识。胸科肿瘤学服务正在进行的研究将筛查肺癌患者的精神障碍，从而促进及时招募研究人员的机会。导师将由史蒂文·萨夫伦博士和霍莉·普里格森博士提供，他们分别是为不同医学人群开发和测试CBT方案以及晚期癌症患者心理障碍的评估和流行病学方面的全国公认的专家。研究的相关性：这项研究将进一步了解焦虑对晚期癌症患者的影响。将开发新的干预措施，以缓解痛苦和提高生活质量。大约30%的晚期肺癌患者经历了衰弱的焦虑症状，这些症状与较差的医疗和心理社会结局有关。本研究的目的是开发和试行一种行为干预方法，能够及时、方便地提供给肿瘤患者。通过这项研究，我们将更深入地了解晚期肺癌患者的心理社会需求，并创建一种最先进的行为干预措施，以解决这些担忧，提高患者的整体生活质量。

DESCRIPTION (provided by applicant): Title: Brief CBT for Anxiety and Advanced NSCLC Project Summary/Abstract Overview: This is an application to develop and preliminarily test cognitive-behavioral therapy (CBT) for the treatment of anxiety in individuals with advanced non-small cell lung cancer (NSCLC). The overall goal is to lay the necessary groundwork for a full-scale randomized controlled trial of this treatment. Background: CBT for anxiety is an evidence-based, validated psychosocial intervention for anxiety which has not been examined in oncology patients in general or advanced lung cancer in particular. Lung cancer is the second most frequently diagnosed cancer and one of the leading causes of death in the U.S. Coping with this diagnosis can cause clinically significant, distressing, and interfering anxiety associated with impaired quality of life and worse medical outcomes. Research Plan: This study will follow NIH-defined guidelines for behavioral therapies development. Accordingly, there will be two phases. The first phase is to adapt state-of-the-art CBT for anxiety to the specific population of patients with advanced NSCLC. This will involve conducting qualitative interviews to obtain feedback from patients with advanced lung cancer on the components of CBT for anxiety, developing an outline of a treatment manual, and piloting the intervention openly. The second phase is a pilot randomized controlled trial of the psychosocial intervention following the treatment manual outline to examine patient acceptability, feasibility of delivery, and an estimation of the effect size for anxiety reduction and improvement in quality of life. Environment: The study will take place at Massachusetts General Hospital, drawing on the clinical and research expertise of the Centers for Cancer Care (the Thoracic Oncology Service) and the Department of Psychiatry's Behavioral Medicine Service which has considerable expertise in cognitive behavioral therapy development and testing. The timely opportunity for study recruitment is facilitated by ongoing research in the Thoracic Oncology Service that will be screening for psychiatric distress in individuals with lung cancer. Mentorship will be provided by Steven Safren, PhD and Holly Prigerson, PhD, nationally-recognized experts in the development and testing of CBT protocols for diverse medical populations and the assessment and epidemiology of psychological disorders among patients with advanced cancer, respectively. Relevance of Research: The study will further understanding of the impact of anxiety on advanced cancer patients. Novel interventions for alleviating distress and improving quality of life will be developed. Approximately 30% of patients with advanced lung cancer experience debilitating anxiety symptoms that are associated with worse medical and psychosocial outcomes. The purpose of the present investigation is to develop and pilot test a behavioral intervention that can be delivered to oncology patients in a timely and accessible manner. Through this study, we will gain a deeper understanding of the psychosocial needs of patients with advanced lung cancer as well as create a state-of-the-art behavioral intervention that addresses these concerns and improves patients' overall quality of life.