Leveraging social connection by including informal caregivers in an internet video conference-based compassion meditation intervention to reduce psychological distress in breast cancer survivors

通过让非正式护理人员参与基于互联网视频会议的同情冥想干预，利用社会联系来减少乳腺癌幸存者的心理困扰

• 批准号: 10518639
• 负责人: THADDEUS PACE
• 金额: $ 36.43万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-11 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10518639
• 关键词: Address; Adult; Aftercare; Anxiety; Attention; Breast Cancer survivor; Cancer Survivor; Caregiver well-being; Caregivers; Caring; Chemotherapy and/or radiation; Cognitive; Cognitive Therapy; Compassion; Diffusion; Distress; Diurnal Rhythm; Effectiveness; Ensure; Exhibits; Family member; Feeling; Goals; Health education; Home; Hydrocortisone; Instruction; Internet; Interpersonal Relations; Intervention; Mediating; Mediator of activation protein; Meditation; Mental Depression; Meta-Analysis; Modality; Operative Surgical Procedures; Pathway interactions; Personal Satisfaction; Pharmacotherapy; Physical activity; Physiology; Randomized; Research; Social isolation; Solid Neoplasm; Stress; Supportive care; Survivors; Technology; Testing; Training; Videoconferencing; Work; attentional control; base; cancer therapy; caregiver education; clinically significant; digital; experience; improved; informal caregiver; mindfulness; mindfulness meditation; negative affect; online intervention; pilot test; primary outcome; psychological distress; recruit; remote delivery; skills; social; synchronous contact; synchronous delivery

ABSTRACT Many breast cancer survivors (estimated 70% in some studies) experience clinically significant depression and/or anxiety (together psychological distress, hereafter distress) in the months and years after finishing cancer treatments. To address this important need, meditation interventions have been developed to reduce distress for breast cancer survivors, while also improving (or stabilizing) objective indicators of stress physiology (i.e., diurnal cortisol rhythm; DCR). In the last several years, progress has been made to deliver these meditation interventions through digital technology to improve scalability and accessibility (i.e., online and/or through apps) to reduce distress experienced by survivors. Online meditation interventions are especially important because they ensure ongoing viability of a popular integrative modality for many survivors who are unable to engage in face-to-face supportive care activities outside the home. Despite progress, existing online meditation interventions have several limitations that undercut their effectiveness to reduce survivor distress. Online meditation interventions have: 1) centered mostly on mindfulness, which does not actively work to cultivate prosocial and interpersonal relationship capacity and provides limited contemplative skills for survivors who may suffer from feelings of social isolation that contribute to distress; 2) often been asynchronous, with no direct interventionist contact over the course of meditation training; and 3) have often not included survivors' informal caregivers (i.e., adult family members who live with and typically provide half the care for survivors). This research will address these limitations. We will build on the rigor of prior research to reduce survivor distress with a compassion meditation intervention called CBCT (Cognitively-Based Compassion Training) for online synchronous delivery by trained interventionists that is also inclusive of caregivers. CBCT is an 8-week intervention that starts with attention and mindfulness but then builds to contemplation about compassion for the self and others, and is different from other meditation interventions (i.e., mindfulness meditation). The goal of CBCT is to directly enhance feelings of social connection, equanimity, and self-compassion, and reduce negative affect, and through these pathways lessen distress. We seek to determine if CBCT reduces distress and improves DCR for survivors compared to an active attention control (Health Education, HE) when delivered remotely by Zoom to both survivors and caregivers as a dyad (i.e., CBCT for dyads; CBCT-D). We will also test whether or not including caregivers in CBCT-D reduces distress and optimizes DCR more than when survivors receive CBCT by themselves alone (i.e., CBCT for survivors; CBCT-S). If successful, this research will provide evidence regarding efficacy of an online, synchronous dyadic CBCT intervention and the extent to which it does so through the mediational pathway of social connection with caregivers. This research will fill an important gap in evidence for interventions that can reduce distress, an NCI priority for the growing numbers of survivors and caregivers.

抽象的 许多乳腺癌存活（在某些研究中估计70％）经历了临床意义的抑郁症 和/或动画（在心理困扰中，以后的困扰）在癌症结束后的几个月和几年 治疗。为了满足这一重要需求，已经制定了冥想干预措施以减少困扰 对于乳腺癌的存活，同时还改善了压力生理的客观指标（即 昼夜的皮质醇节奏； DCR）。在过去的几年中，已经取得了进步来提供这些冥想 通过数字技术进行干预以提高可伸缩性和可访问性（即在线和/或通过应用程序） 减少生存经历的困扰。在线冥想干预措施尤其重要，因为 它们确保了许多无法参与的表面的流行综合方式的生存能力 在家外面的面对面支持护理活动。尽管进展，现有的在线冥想 干预措施有几个限制，削弱了它们减少幸存者困扰的有效性。在线的 冥想干预措施具有：1）主要集中在正念上，这并不积极培养 亲社会和人际关系的关系能力，为生存提供有限的沉思技能，可能 遭受社会隔离的感觉，导致困扰； 2）通常是异步的，没有直接 干预主义者在冥想训练过程中接触； 3）通常不包括冲浪者的非正式 护理人员（即，与之同住并通常提供一半的生存护理的成年家庭成员）。这 研究将解决这些局限性。我们将基于先前研究的严格性，以减少生存困扰 通过同情的冥想干预措施，称为CBCT（基于认知的同情培训）用于在线 训练有素的干预主义者同步交付也包括照料者。 CBCT是为期8周 干预始于关注和正念，但随后建立在对同情心的满足 自我和他人，与其他冥想干预措施（即正念冥想）不同。目标 CBCT将直接增强社交联系，宗教和自我同情的感觉，并减少负面 影响，通过这些途径减少了困扰。我们试图确定CBCT是否减少了困扰和 与主动注意力控制（健康教育，HE）相比，可以改善生存的DCR 通过变焦远程向表面和护理人员作为二元组（即CBCT用于二元组； CBCT-D）。我们还将测试 与幸存者相比 独自接受CBCT（即CBCT生存； CBCT-S）。如果成功，这项研究将提供 有关在线，同步二元CBCT干预及其程度的证据 通过与照顾者的社会联系的中介途径来做到这一点。这项研究将填补重要的 差距可以减少痛苦的干预措施，这是越来越多的幸存者的NCI优先级 和看护人。