Couple-based meditation program for patients with metastatic lung cancer and their partners

 描述(由申请人提供)：超过一半的新肺癌病例被诊断为已有远处转移。鉴于转移性肺癌的不治之症，生活质量(QOL)是首要关注的问题。患者通常会经历疲劳、睡眠障碍、抑郁和呼吸短促，以及影响其生活质量的精神/生存苦恼。此外，鉴于这些症状，患者高度需要护理和支持，并经常依赖他们的照顾者。患者报告说，他们的配偶/浪漫伴侣是他们最重要和最有价值的支持和关怀来源；然而，照顾会造成身体和情感上的损失。伴侣经常报告心理困扰、疲劳和睡眠障碍的比率很高，通常与患者的比率一样高，这可能会影响他们能够为患者提供的护理质量。考虑到夫妻生活质量的相互依赖性质，糟糕的照顾者生活质量可能会损害患者的生活质量，反之亦然。此外，尽管夫妻经常报告与癌症有关的担忧，但他们可能无法向对方透露这些担忧。这种对担忧的抑制进一步加剧了夫妻的痛苦。因此，迫切需要开发支持性护理计划，帮助患者和他们的伴侣共同管理症状，并披露他们的担忧，以促进心理调整。冥想训练已被证明能改善癌症患者的生活质量，但这种类型的干预对转移患者是否可行和有效尚不清楚。 疾病。更不为人所知的是一种基于伴侣的冥想方法，这种方法结合了伴侣辅助的情绪披露技术。因此，这项研究将检验包含情绪披露的冥想训练是否能改善受转移性肺癌影响的夫妇的生活质量。这项拟议的研究将随机将夫妻分配到以夫妻为基础的冥想计划、注意力控制组或接受常规护理的等待名单控制组。在随机化之前，患者和伴侣将完成标准的生活质量自我报告测量。可行性数据将被记录下来(例如，同意、自然减员和遵守)。我们将纳入4次干预(60-75分钟。每个)纳入患者的癌症治疗计划，因为它可能在这个时候特别有用，以缓解身体症状和心理痛苦。夫妇将在干预结束时和三个月后进行重新评估。这些数据将解决两个基本问题：1)在接受治疗(放疗和/或化疗)的转移性肺癌患者及其伴侣中实施基于夫妇的冥想计划是否可行？以及，2)是否有初步证据表明治疗对生活质量的影响有效？我们将利用这些发现来设计一项未来的更大规模的研究，以进一步测试这种干预的有效性。该项目代表了对转移性肺癌患者及其伴侣的生活质量进行管理的主要步骤，转移性肺癌患者及其伴侣是一个脆弱但未得到充分研究的人群。

 DESCRIPTION (provided by applicant): Over half of new lung cancer cases are diagnosed with already distant metastases. Given the incurable nature of metastatic lung cancer, quality of life (QOL) is a primary concern. Patients commonly experience fatigue, sleep disturbances, depression, and shortness of breath as well as spiritual/existential distress compromising their QOL. Moreover, in light of these symptoms, patients have a high need for care and support and are often dependent on their caregivers. Patients report that their spouses/romantic partners are their most important and valued source of support and care; yet, caregiving exerts physical and emotional toll. Partners often report high rates of psychological distress, fatigue, and sleep disturbances, often as high as patients' rates, which may compromise the quality of care they are able to provide to the patient. Given the interdependent nature of QOL in couples, poor caregiver QOL may undermine patient QOL and vice versa. Additionally, although couples frequently report cancer-related concerns, they may not be able to disclose these concerns to each other. This holding back of concerns further exacerbates couples' distress. Therefore, there is a high need to develop supportive care programs that help patients and their partners to manage symptoms together as well as disclose their concerns to facilitate psychological adjustment. Meditation training has been shown to improve the QOL of cancer patients, but little is known whether this type of intervention is feasible and efficacious for patients with metastatic disease. Even less is known about a couple-based meditation approach that incorporates partner-assisted emotional disclosure techniques. Thus, this investigation will examine if a meditation training that integrates emotional disclosure improves QOL in couples affected by metastatic lung cancer. The proposed research will randomly assign couples to either the couple-based meditation program, an attention control group or a waitlist control group receiving usual care. Prior to randomization, patients and partners will complete standard QOL self-report measures. Feasibility data will be documented (e.g., consent, attrition, and adherence). We will incorporate the 4-session intervention (60-75 min. each) into patients' cancer treatment plans, as it may be especially useful at this time to alleviate physical symptoms and psychological distress. Couples will be re-assessed at the end of the intervention and three months later. These data will address two fundamental questions: 1) is it feasible to implement a couple-based meditation program in patients with metastatic lung cancer receiving treatment (radiotherapy and/or chemotherapy) and their partners? And, 2) is there preliminary evidence of treatment efficacy in regard to QOL outcomes? We will use these findings to design a future, larger study to further test the efficacy of this intervention. This project represents a major ste towards managing QOL in patients with metastatic lung cancer and their partners, a vulnerable yet understudied population.