Psychosocial Impact of Pediatric Bone Marrow Transplant

儿科骨髓移植的心理社会影响

• 批准号: 6917885
• 负责人: Sean Phipps
• 金额: $ 37.1万
• 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 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6917885
• 关键词: adolescence (12-20); alternative medicine; behavioral /social science research tag; bone marrow transplantation; clinical research; clinical trials; family structure /dynamics; human subject; human therapy evaluation; longitudinal human study; massage therapy; middle childhood (6-11); outcomes research; patient care management; patient oriented research; pediatric neoplasm /cancer; prognosis; psychological aspect of cancer; psychological models; psychological stressor; psychological tests; quality of life; social psychology; social support network; adolescence (12-20); alternative medicine; behavioral /social science research tag; bone marrow transplantation; clinical research; clinical trials; family structure /dynamics; human subject; human therapy evaluation; longitudinal human study; massage therapy; middle childhood (6-11); outcomes research; patient care management; patient oriented research; pediatric neoplasm /cancer; prognosis; psychological aspect of cancer; psychological models; psychological stressor; psychological tests; quality of life; social psychology; social support network

DESCRIPTION (provided by applicant): Advances in the technology and supportive care associated with bone marrow and stem cell transplantation (BMT) have led to improved medical outcomes for children with cancer and other catastrophic illnesses. However, the BMT procedure remains a prolonged, physically and emotionally demanding experience for patients and families. Our current research has demonstrated that patients experience a high level of somatic distress and associated mood disturbance during the acute phase of BMT, and further, that parental caregivers also experience a high level of emotional distress during the same procedure. Although this distress is relatively transient, research on long-term psychosocial outcomes in BMT suggests that it may be associated with later disturbances in the social functioning, self-esteem, and general emotional well-being of survivors, as well as with an increased risk of post-traumatic stress symptoms in survivors and their parents. Novel interventions to reduce the stresses of BMT are needed, but few empirical studies of psychosocial interventions during BMT have been reported, and those have involved only adult patients. The results of our pilot study testing a multi-component, health promotion intervention for patients during their BMT hospitalization indicated that two components; massage and humor therapy, were rated as significantly more helpful than the others. These findings have guided the design of this proposed randomized intervention trial. The overall aim of the proposed project is to evaluate the impact of a health promotion intervention for childrenundergoing bone marrow or stem cell transplant (BMT). The intervention is complementary in nature, designed to increase the experience of positive affect and reduce somatic distress and mood disturbance, that is, to improve overall child well being. The study will utilize a positive psychology model, exploring the hypothesis that unproved outcomes will be mediated by the increased experience of positive affect states brought about by the intervention. The primary focus is on a child-targeted intervention that includes massage therapy and humor therapy. The study will also assess whether the addition of a similar parent-targeted intervention involving massage therapy and relaxation training will provide significant benefits beyond those provided by the child-targeted intervention alone. Both child and parent interventions will include a significant education component, guided by our model of positive psychology. The study will utilize a 3-group design, with participants randomized to receive: 1) a child-targeted intervention; 2) a child targeted intervention plus a parent-targeted intervention; 3) standard care. Primary outcomes include child positive affect, somatic distress and mood disturbance, as well as measures of parental positive affect and distress. Additional objectives of the study include examining the impact of the intervention on short-term medical outcomes, as well as measures of child adjustment and parent and child post-traumatic stress symptoms (PTSS) at 6 months post-BMT. Finally, analyses will explore hypotheses specific to the positive psychology model, testing the role of positive affect and dispositional optimism as mediators and moderators of the intervention on child and parent well being.

描述（由申请人提供）：技术的进步和支持性 与骨髓和干细胞移植（BMT）相关的护理已LED 改善癌症儿童和其他灾难性的儿童的医疗结果 疾病。但是，BMT程序在身体上保持延长，并且 对患者和家庭的情感苛刻经验。我们的目前 研究表明，患者的体细胞水平很高 在BMT的急性阶段的困扰和相关的情绪干扰，以及 此外，父母的照顾者也经历了高水平的情感 在同一过程中的困扰。虽然这种困扰相对 对BMT中长期社会心理结局的暂时研究表明 可能与以后在社会功能中的干扰有关， 自尊心，幸存者的一般情感幸福感以及 幸存者及其创伤后压力症状的风险增加 父母。需要采取新的干预措施来减轻BMT的压力，但很少 据报道，BMT期间的社会心理干预措施的经验研究， 那些只涉及成年患者。我们的试点研究的结果 测试患者的多组分，健康促进干预措施 他们的BMT住院治疗表明两个组成部分。按摩和幽默 治疗的评价比其他疗法更有帮助。这些 调查结果指导了该提出的随机干预试验的设计。 拟议项目的总体目的是评估健康的影响 促进儿童骨髓或干细胞的促进干预措施 移植（BMT）。干预本质上是互补的，旨在 增加积极影响的经验，减少躯体困扰和情绪 干扰，即改善整体儿童健康。研究将 利用积极的心理学模型，探讨了未经证实的假设 成果将由积极影响状态的增长经验来调节 干预带来。主要重点是针对孩子的 包括按摩疗法和幽默疗法的干预措施。研究将 还评估是否添加类似的父母靶向干预措施 涉及按摩疗法和放松培训将提供重要的 仅由儿童靶向干预提供的好处。两个都 儿童和父母干预措施将包括重要的教育部分， 在我们积极心理学模型的指导下。该研究将利用3组 设计，参与者随机接收：1）一个孩子靶向 干涉; 2）一个针对孩子的干预加上父母的靶向 干涉; 3）标准护理。主要结果包括儿童积极影响， 躯体困扰和情绪障碍以及父母积极的措施 影响和困扰。研究的其他目标包括检查 干预对短期医疗结果的影响以及措施 儿童调整以及创伤后压力症状（PTSS）的父母和儿童 BMT后6个月。最后，分析将探讨特定于 积极心理学模型，测试积极影响的作用和 作为对儿童干预的调解人和主持人的倾向乐观 和父母健康。