A Problem-Solving Intervention for Family Caregivers in Palliative Oncology

 描述(由申请人提供)：姑息肿瘤提供者是理想的位置，以改善数百万家庭成员和朋友的癌症之旅，他们对重症患者的护理至关重要。近几十年来，癌症护理的主要场所已从医院住院部转移到门诊诊所，留下家庭照顾者负责在家中提供大部分患者护理，往往几乎没有支持或准备。与家庭照料相关的众多压力因素往往会引起照顾者焦虑、抑郁、疲劳、忽视自我照顾，对于特别紧张的照顾者来说，心理症状反映了创伤幸存者的经历。与国家癌症研究所致力于在整个疾病轨迹上支持癌症患者家庭的承诺一致，我们寻求研究技术中介的问题解决干预的可行性，旨在改善接受门诊姑息治疗的癌症患者的家庭照顾者的生活质量，并减少他们的心理痛苦。具体地说，我们的目标是：1)研究与核心干预内容的招募、随机化、保留和忠诚度相关的干预措施的可行性；2)调查干预措施对家庭照顾者焦虑、抑郁和生活质量的影响；3)从参与者的角度探讨干预措施带来的好处和挑战。为了实现这些目标，我们将招募82名接受门诊姑息治疗的癌症患者的家庭照顾者，并将其随机分配到两组(常规护理和干预)，并收集定量和定性的数据，这些数据将被分析，以便为未来的大规模随机临床试验提供解决问题的干预措施。

 DESCRIPTION (provided by applicant): Palliative oncology providers are ideally situated to improve the cancer journey for the millions of family members and friends who are vital to the care of seriously ill patients. In recent decades, the primary setting for cancer care has shifted from the hospital inpatient unit to the outpatient clinic, leaving family caregivers responsible fo providing the majority of patient care in the home, often with little support or preparation. The numerous stressors associated with family caregiving often give rise to caregiver anxiety, depression, fatigue, neglect of self-care and, for particularly strained caregivers, psychological symptoms that mirror those experienced by trauma survivors. In congruence with the National Cancer Institute's commitment to supporting families of individuals with cancer across the full disease trajectory, we seek to examine the feasibility of a technologically-mediated problem-solving intervention designed to improve the quality of life and decrease the psychological distress of family caregivers of cancer patients receiving outpatient palliative care. Specifically we aim to 1) examine the feasibility of the intervention relative to recruitment, randomization, retention, and fidelity to core intervention components; 2) investigate the impact of the intervention on family caregiver anxiety, depression, and quality of life; and 3) explore the benefits and challenges associated with the intervention from the perspective of participants. To accomplish these aims, we will recruit and randomly assign 82 family caregivers of cancer patients receiving outpatient palliative care into two groups (usual care and intervention) and collect quantitative and qualitative data, which will be analyzed to inform a future large- scale randomized clinical trial of the problem-solving intervention.