Problem-Solving Skills Training for Clinicians Providing Psychosocial Care in Pediatric Oncology

 说明(申请人提供)：儿童的情绪调整与父母，特别是母亲对其自身心理/身体健康的报告；健康信念；应对方式；以及对家庭和社区社会支持的看法有关。在20世纪80年代末发表的一份关于儿童癌症患者母亲幸福感和健康兄弟姐妹功能的报告中，Sahler等人发现，母亲幸福感水平较低与健康兄弟姐妹的适应能力较差相关。研究还发现，与适应能力较好的兄弟姐妹的母亲相比，适应能力较差的兄弟姐妹的母亲通过获得更多的资源来应对。然而，有趣的是，这些母亲对她们的资源的满意度非常低。目前尚不清楚他们的不满是因为获得了错误的资源；他们无法足够清楚地表达他们的需要以获得适当的帮助；或者他们未能有效地应用所提供的任何建议。这些发现让我们假设，一种系统的方法，教患有癌症儿童的母亲如何识别和解决问题，以提高应对技能，将减少她们感受到的痛苦，并提高她们的自我满意度和幸福感水平。Bright Ideas的问题解决技能培训(Psst)范式现已在830名最近确诊的儿童癌症患者的母亲身上进行了测试，结果发现，这对降低她们的痛苦程度非常有效。它也是一个 很少有项目被NCI指定为研究测试治疗和干预计划(RTIP)，并被给予5.0/5.0的传播能力分数。利用创新理论的扩散原则，这项建议旨在通过与儿童肿瘤学会(COG)、儿科肿瘤社会工作者协会(APOSW)、儿科血液/肿瘤护士协会(APHON)和儿科心理学家协会(SPP)合作培训200名专业人员来建设能力，该组织专门关注血液学/肿瘤学会(SPP)如何为美国儿童癌症中心的母亲、父亲和其他主要照顾者提供PSST。为该项目开发的基于网站的材料将使Psst在世界范围内可用。

 DESCRIPTION (provided by applicant): The emotional adjustment of children has been linked to parental, especially maternal, reports of their own mental/physical health; health beliefs; coping styles; and perceptions of family and community social support. In a report on maternal well-being and the functioning of healthy siblings of pediatric cancer patients published in the late 1980s, Sahler et al found that lower levels of maternal well-being were correlated with poorer adaptation among healthy siblings. The study also found that mothers of poorly adjusted siblings coped by accessing more resources than did mothers of better adjusted siblings. Interestingly, however, these mothers' level of satisfaction with their resources was remarkably low. It is unknown whether their dissatisfaction was due to accessing the wrong resources; their inability to articulate their needs with sufficient clarity to obtain appropriate help; or their falure to effectively apply whatever advice was offered. These findings led us to hypothesize that a systematic method for teaching mothers of children with cancer ways to identify and solve problems to increase coping skills would reduce their perceived distress and increase their levels of self- satisfaction and well-being. The Bright IDEAS paradigm of Problem Solving Skills Training (PSST) has now been tested in > 830 mothers of recently diagnosed childhood cancer patients and found to be highly effective in reducing their levels of distress. It is also one of a very few programs to have been designated a Research- tested Therapy and Intervention Program (RTIP) by the NCI and given a Dissemination Capability score of 5.0/5.0. Using the principles of Diffusion of Innovation Theory, this proposal is designed to build capacity by training 200 professionals in partnership with the Children's Oncology Group (COG), the Association of Pediatric Oncology Social Workers (APOSW), the Association of Pediatric Hematology/Oncology Nurses (APHON), and the Society of Pediatric Psychologists (SPP) special interest group in hematology/oncology how to provide PSST to mothers, fathers, and other primary caregivers at child cancer centers throughout the US. Website-based materials developed for this project will make PSST available world-wide.