EHealth Mindful Movement and Breathing to Improve Gynecologic Cancer Surgery Outcomes

项目摘要 改善急性围手术期疼痛和共病症状的管理（即，睡眠障碍， 心理困扰）在妇女接受手术的怀疑妇科恶性肿瘤可能 主动接触高危人群，减轻慢性疼痛的总体负担。事实上， 妇女，手术，并被诊断患有癌症是最容易受到慢性疾病的亚组。 痛苦身心干预通常寻求非药物方法治疗疼痛和其他疾病。 症状管理，特别是癌症患者。瑜伽是一种多模式的身心干预， 通过心理和生理机制最佳地解决疼痛和共病症状， 受止痛药的影响瑜伽与其他非药物干预相比具有潜在优势 因为它的多个组成部分，也支持鼓励流动性和深度的通常护理目标， 呼吸并因此可以改善额外的手术并发症（例如，肠梗阻、深静脉血栓形成）。的 提出的正念运动和呼吸（MMB）简短的瑜伽干预是创新的，因为它适应了关键 长期干预措施的要素，以短期形式，可以在急性 围手术期拟议的研究将适应已经开发的亲自MMB干预 和亲自注意力控制（AC）到电子健康格式（目标I）。目标二将实地测试执行战略 目标III将确定eMMB和AC的可行性和可接受性，以减少 疼痛和其他手术结果通过一项探索性随机临床试验， 疑似妇科恶性肿瘤的手术。开发和评估AC集团在一个 电子健康干预将有助于拟议研究的下一阶段，并可能适用于 更广泛地研究身心干预。在完成这项可行性研究后，我们会全面- 对优化的eMMB减轻疼痛、睡眠障碍和 妇科癌症手术后的心理困扰。干预的简洁性和可及性，以及 瑜伽的日益普及，使eMMB成为未来传播的有力候选者。如果我们 证明了eMMB在改善接受手术治疗的女性的手术结局方面的有效性。 疑似妇科恶性肿瘤，结果可能推广到其他围手术期患者， 这对减少受慢性疼痛影响的不断增长的人口具有重要的公共卫生意义。拟议 研究解决了国家补充和综合健康中心概述的优先事项（即， 研究用于症状管理的身心方法）。

PROJECT SUMMARY Improved management of acute perioperative pain and co-morbid symptoms (i.e., sleep disturbances, psychological distress) among women undergoing surgery for suspected gynecologic malignancies may proactively reach an at-risk population and reduce the overall burden of chronic pain. In fact, patients who are women, have surgery, and are diagnosed with cancer are among the subgroups most vulnerable to chronic pain. Mind-body interventions are commonly sought after nonpharmacological approaches for pain and other symptom management, particularly in cancer patients. Yoga is a multimodal mind-body intervention that may optimally address pain and co-morbid symptoms through psychological and physiological mechanisms not affected by pain medication. Yoga has a potential advantage over other nonpharmacological interventions because of its multiple components that also support the usual care goals of encouraging mobility and deep breathing and thus may improve additional surgical complications (e.g., ileus, deep venous thrombosis). The proposed Mindful Movement and Breathing (MMB) brief yoga intervention is innovative because it adapts key elements of a longer intervention to a short-term format that can be implemented during the acute perioperative timeframe. The proposed research will adapt the already developed in-person MMB intervention and in-person attention control (AC) to an eHealth format (Aim I). Aim II will field test implementation strategies for the resulting eMMB, and Aim III will determine feasibility and acceptability of the eMMB and AC to reduce pain and other surgical outcomes through an exploratory randomized clinical trial among women undergoing surgery for suspected gynecologic malignancies. Developing and assessing the feasibility of an AC group in an eHealth intervention will be instrumental for the next stages of the proposed research and may be applicable to the study of mind-body interventions more broadly. Following this feasibility study, we will conduct a fully- powered investigation of the efficacy of the optimized eMMB for reducing pain, sleep disturbance, and psychological distress after gynecologic cancer surgery. The brevity and accessibility of the intervention, and the increasing popularity of yoga, make the eMMB a strong candidate for future dissemination. If we demonstrate efficacy of the eMMB for improving surgical outcomes of women who undergo surgery for a suspected gynecologic malignancy, results may be generalizable to other perioperative patients and have important public health implications for reducing the growing population affected by chronic pain. The proposed research addresses priorities outlined by the National Center for Complementary and Integrative Health (i.e., investigates a mind-body approach for symptom management).