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.

骨髓移植（BMT）在儿科治疗中的应用 过去十年来，恶性肿瘤呈指数增长。现在， 美国每年对儿童和儿童进行超过 2,000 次 BMT 预计青少年和 BMT 率将持续增加。骨髓移植是 一种强化的、对体力要求较高的治疗方案，代表 对患者和家庭来说是一个非常重要的压力源。尽管有无数 BMT 适应不良心理社会反应的临床报告，实证 有关特定行为和心身结果的可用数据 儿童群体中缺乏 BMT。获得这些经验数据 对于制定预防性干预措施至关重要 BMT 的有效社会心理支持计划。患者。这 主要目标是识别行为、情感和躯体 儿科 BMT 急性期后遗症的决定因素 将在风险背景下分析患者对 BMT 的反应 弹性模型，以确定促进健康的保护因素 心理社会结果。这项研究的数据将推动临床 实践促进我们对儿童复原力的理解。这将是 使用前瞻性、纵向设计和评估来完成 移植前开始，移植后持续 3 年。 移植前获得的数据包括纵向基线测量 比较，以及心理预测变量。潜在的 要研究的保护因素包​​括： a) 儿童倾向（轨迹） 控制、应对方式、认知方式）； b) 家庭环境（凝聚力、 居民的冲突、表达和应对行为 父母）； c) 外部社会支持资源。主要重点是 数据收集将在 BMT 住院的急性期进行 移植后前 6 个月的过渡期。 重复测量有关患者躯体、行为和 在此期间的情感反应将被用作 主要临床关注的结果并作为后期结果的预测因子。 长期结果将通过患者的综合测量来评估 社交能力、行为调整和情绪健康， 以及心理教育功能。 拟议的研究将通过鉴定来推进临床护理 a) 特定的临床问题及其相关因素 b) 需要干预的特定高风险亚组 应该有针对性。 它将促进对儿童的理论理解 促进复原力的应对过程和保护机制 对抗重大的童年压力。