Couples and Cancer: Building Partner Efficacy in Caring

夫妻与癌症：建立伴侣的护理效能

• 批准号: 7219065
• 负责人: WILLIAM B COLLINGE
• 金额: $ 41.09万
• 依托单位: COLLINGE AND ASSOCIATES
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-08-01 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7219065
• 关键词: caregivers; clinical research; conditioning; family; neoplasm /cancer; quality of life; reduction; stress; touch

DESCRIPTION (provided by applicant): This proposal is to develop and evaluate a multimedia program to instruct lay caregivers in safe and informed use of massage as a form of support in cancer. Phase I focus groups identified common concerns about use of touch as support in cancer. We then delivered instruction using a workshop format. Feasibility was demonstrated by significant and sustained increases in use of massage, self-efficacy, satisfaction, and qualitative data from focus groups. In Phase II we will develop a DVD with manual (each in English and Spanish) to deliver the instruction, and evaluate its effects in a randomized controlled trial. The final product will be a multimedia program for use by the mass audience of family members and other lay care providers for cancer patients. Specific Aims: 1. Produce a multimedia program to deliver instructional content in massage for lay care partners and cancer patients. 2. Determine the effects of the multimedia program on caregiver esteem and stress and on the frequency and duration of the care partner's provision of their assigned form of support to the patient. 3. Determine the effects of the multimedia program on patient symptom levels, functional quality of life, perceived stress, and physiologic indices of stress. Hypotheses: 1. Partners in the massage condition will show greater gains in caregiver esteem and reductions in perceived stress; and they will provide their assigned form of support with greater frequency and duration than will partners in the quality time condition. 2. Patients in the massage condition will have greater improvements in symptom levels, functional quality of life, and perceived stress than will patients in the quality time condition. 3. Patients in the massage condition will have reduced morning rise at 30 min post awakening in salivary cortisol relative to controls and an enhanced diurnal decline from waking to evening sample. Salivary DHEA will be increased overall in patients receiving the massage intervention. Secondary aim: Examine the impact of the multimedia program on care partner concerns about use of touch as a form of support, and on self-efficacy in massage. Secondary hypothesis: Partners assigned to the massage condition will experience greater reduction in levels of concern about touch and increase in self- efficacy in using touch as support over time. Method: Randomized controlled trial with 100 patient/caregiver dyads, over a 6-month period. Subjects will use standardized self- report measures and investigator-generated measures. Patients will use a new non- invasive approach to saliva collection for physiological data. Relevance to public health: Home-based caregiving in cancer is a rapidly expanding societal phenomenon. Simple massage techniques have been shown to bring significant relief from suffering in cancer, but lay caregivers are reluctant to use touch for fear of causing harm. The proposed educational product will promote wide societal acceptance of safe and informed use of touch as palliative care in cancer by family members and other lay caregivers. This project will develop an instructional multimedia program to promote wide societal acceptance and normalization of the safe and informed use of touch as a form of support by family members and other lay caregivers for people with cancer. If successful the program will contribute to enhanced caregiver self-efficacy, reduced suffering by patients, and reduced costs associated with amelioration of symptoms and side effects of treatment.

描述（由申请人提供）：该提案是为了制定和评估多媒体计划，以指导外行护理人员安全且明智地使用按摩作为癌症的支持形式。第一阶段的焦点小组确定了对使用触摸作为癌症支持的普遍关注。然后，我们使用车间格式提供了指导。从焦点组的按摩，自我效能感，满意度和定性数据的使用，大幅度和持续的增加证明了可行性。在第二阶段，我们将使用手册（每项用英语和西班牙语）开发DVD来提供该说明，并在随机对照试验中评估其效果。最终产品将是一项多媒体计划，供家庭成员和其他外行护理提供者用于癌症患者。具体目的：1。制定多媒体计划，在按摩中为外行伴侣和癌症患者提供教学内容。 2.确定多媒体计划对护理人员的自尊和压力的影响以及护理伙伴提供其为患者提供的支持形式的频率和持续时间。 3。确定多媒体计划对患者症状水平，功能质量，感知压力和压力的生理指标的影响。假设：1。处于按摩条件的伴侣将表现出更大的看护者的自尊心和减少的压力；与在优质时间条件下的合作伙伴相比，他们将提供更高的频率和持续时间的指定形式的支持形式。 2。按摩条件下的患者的症状水平，功能质量和感知压力的改善要比在优质时间条件下的患者有所改善。 3。按摩条件下的患者将减少唾液皮质醇相对于对照组的唾液皮质醇后30分钟的早晨升高，并且从醒来到晚上样品的昼夜下降增加。接受按摩干预的患者总体上将增加唾液DHEA。次要目的：检查多媒体计划对使用触摸作为一种支持形式以及按摩中的自我效能的关注。次要假设：分配给按摩条件的合作伙伴将使人们对触摸的关注程度更大，而使用触摸作为支持的自我效能的增加水平。方法：在6个月内，有100名患者/护理人员二元组的随机对照试验。受试者将采用标准化的自我报告措施和研究者制定的措施。患者将使用一种新的非侵入性唾液收集方法来收集生理数据。与公共卫生的相关性：癌症的家庭护理是一种迅速扩大的社会现象。简单的按摩技术已被证明可以减轻癌症的痛苦，但外行护理人员不愿使用触摸来害怕造成伤害。拟议的教育产品将促进家庭成员和其他外行护理人员在癌症中对触摸的安全和明智使用的社会接受。该项目将开发一项教学多媒体计划，以促进对触摸的安全和知情使用的广泛社会接受和正常化，作为家庭成员和其他外行护理人员对癌症患者的支持形式。如果成功，该计划将有助于增强护理人员的自我效能感，患者的痛苦减少，并降低与症状改善和治疗副作用相关的成本。