PSYCHOSOCIAL IMPACT OF PEDIATRIC BONE MARROW TRANSPLANT

儿科骨髓移植的心理社会影响

• 批准号: 2101361
• 负责人: Sean Phipps
• 金额: $ 9.49万
• 依托单位: ST. JUDE CHILDREN'S RESEARCH HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-01 至 1999-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2101361
• 关键词: adolescence (12-20); bone marrow transplantation; child (0-11); child behavior; coping; emotional adjustment; family structure /dynamics; health behavior; human subject; longitudinal human study; pediatric neoplasm /cancer; prognosis; psychological models; psychological stressor; psychological tests; social support network

The use of bone marrow transplantation (BMT) for treatment of pediatric malignancies has increased exponentially over the past decade. Currently, more than 2,000 BMTs are performed annually in the U.S. on children and adolescents and continued increase in rates of BMT are expected. BMT is an intensive, physically demanding treatment regimen, which represents a very significant stressor for patients and families. Despite numerous clinical reports of maladaptive psychosocial responses to BMT, empirical data available regarding specific behavioral and psychosomatic outcomes of BMT in pediatric populations is lacking. Obtaining this empiric data is essential for the development of preventive interventions and effective programs of psychosocial support for BMT. patients. The primary goal is to identify the behavioral, affective and somatic sequelae of pediatric BMT during the acute phase of determinants of patient response to BMT will be analyzed in the context of a risk- resiliency model, to identify protective factors that promote healthier psychosocial outcomes. Data from this study will advance clinical practice promote our understanding of childhood resiliency. This will be accomplished using the prospective, longitudinal design, with assessments that begin pre-transplant, and continue for 3 years post-transplant. Data obtained pre-transplant includes baseline measures for longitudinal comparison, as well as psychologic predictor variables. Potential protective factors to be studied include: a) child disposition (locus of control, coping style, cognitive style); b) family environment (cohesion, conflict, expressiveness, and the coping behavior of the resident parent); and c) external social support resources. The major focus of data collection will occur during the acute phase of BMT hospitalization through the transition period of the first 6 months post-transplant. Repeated measures data regarding the patients' somatic, behavioral and affective responses during this period will be utilized both as an outcome of primary clinical interest and as a predictor of later outcome. Long-term outcome will be assessed with comprehensive measures of patient social competence, behavioral adjustment, and emotional wellbeing, as well as psychoeducational function. The proposed studies will advance clinical care through identification of a) specific clinical problems and the factors associated with their occurrence, and b) specific high risk subgroups for whom interventions should be targeted. It will advance theoretical understanding of child coping processes and protective mechanisms which promote resilience against significant childhood stressors.

使用骨髓移植（BMT）治疗小儿 在过去的十年中，恶性肿瘤呈指数增长。现在， 每年在美国每年对儿童进行2,000多个BMT和 预计青少年和BMT率的持续增加。 BMT是 一种密集的，身体要求的治疗方案，代表 患者和家庭的压力非常重要。尽管有很多 对BMT的不良适应社会心理反应的临床报道，经验 有关特定行为和心身结果的可用数据 缺乏小儿人群中的BMT。获得此经验数据 对于预防干预措施的制定至关重要 有效的BMT心理社会支持计划。患者。这 主要目标是确定行为，情感和躯体 小儿BMT的后遗症，急性阶段的急性阶段 患者对BMT的反应将在风险的背景下进行分析 弹性模型，以识别保护性因素，以促进更健康 社会心理结果。这项研究的数据将推进临床 练习促进我们对童年弹性的理解。这将是 使用预期的纵向设计完成了评估 这开始了移植前，并在移植后三年持续。 获得移植前的数据包括纵向的基线测量 比较以及心理学预测变量。潜在的 要研究的保护因素包​​括：a）儿童处置（ 控制，应对风格，认知风格）； b）家庭环境（凝聚力， 冲突，表现力和居民的应对行为 父母）; c）外部社会支持资源。主要重点 数据收集将在BMT住院的急性阶段发生 在移植后6个月的过渡期间。 重复衡量有关患者的体细胞，行为和 在此期间，情感反应将被用作 主要临床兴趣的结果，作为后期结果的预测指标。 长期结局将通过全面的患者评估来评估 社会能力，行为调整和情感福祉， 以及心理教育功能。 拟议的研究将通过识别来提高临床护理 a）特定的临床问题及其相关的因素 发生，b）干预措施的特定高风险亚组 应针对目标。 它将提高对孩子的理论理解 应对过程和保护机制，以促进弹性 反对重大的童年压力源。