Videoconference CBT for Rural Breast Cancer Survivors with Cognitive Complaints

针对有认知障碍的农村乳腺癌幸存者的视频会议 CBT

• 批准号: 8325524
• 负责人: Robert J Ferguson
• 金额: $ 14.36万
• 依托单位: EASTERN MAINE MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8325524
• 关键词: Adjuvant Chemotherapy; Adult; Aftercare; Age; Analysis of Variance; Anxiety; Anxiety Disorders; Attention; Auditory; Behavioral; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caring; Chemotherapy-Oncologic Procedure; Chronic; Clinic; Cognitive; Cognitive Therapy; Communication; Data; Devices; Disease; Education; Enrollment; Etiology; Failure; Fatigue; Foundations; Health Services Accessibility; Healthcare; Hour; Impaired cognition; Individual; Intervention; Knowledge; Length; Life; Link; Maine; Malignant Neoplasms; Measures; Medical; Memory; Methods; Mood Disorders; Neurobehavioral Manifestations; Neurologic; Neuropsychological Tests; Outcome; Outcome Measure; Participant; Patient Self-Report; Perceived quality of life; Performance; Pilot Projects; Population; President' s Cancer Panel; Property; Publishing; Quality of life; Randomized; Randomized Controlled Trials; Recording of previous events; Rehabilitation therapy; Reporting; Research; Research Infrastructure; Risk; Rural; Rural Population; Services; Site; Staging; Subgroup; Supportive care; Survivors; Symptoms; Target Populations; Technology; Teleconferences; Telephone; Time; Training; Underserved Population; Videoconferences; Videoconferencing; Visit; Waiting Lists; Woman; base; cancer care; chemotherapy; clinically significant; cognitive change; coping; cost; design; experience; follow-up; health information technology; improved; indexing; innovation; malignant breast neoplasm; member; memory process; neuropsychological; new technology; outreach; processing speed; programs; satisfaction; survivorship; telehealth; trial comparing; underserved rural area; visual memory

DESCRIPTION (provided by applicant): Cognitive dysfunction associated with cancer chemotherapies can have a dramatic effect on cancer survivor quality of life and is recognized as a growing survivorship problem. However, the etiology of chemotherapy- related cognitive change is unknown, with no current broadly validated treatment. The PI is developing a brief cognitive-behavioral therapy (CBT; Memory and Attention Adaptation Training; MAAT) designed to help cancer survivors self-manage and cope with daily memory failure. Preliminary research suggests MAAT may improve self-reported daily cognitive failures and verbal memory performance, and survivors rate it with strong satisfaction, but more research is needed. The proposed research aims to evaluate a revised and more intense version of MAAT (increase from 4 to 8 visits) delivered through videoconferencing technology to aid rural breast cancer survivors with chemotherapy-related cognitive complaints-individuals with geographic and cost barriers to survivorship services. MAAT will be compared to a videoconference supportive therapy (ST). Thus, this study seeks to evaluate feasibility of MAAT delivered through videoconference technology. Participants. 48 women treated for stage I, II, or IIIa breast cancer with chemotherapy-related cognitive complaints, 6 months past last chemotherapy and who do not have other neurologic or psychiatric histories, or untreated anxiety or mood disorders will be enrolled. Intervention. MAAT-Video (MAAT-V) will consist of 8 weekly one-hour group sessions consisting of 2-4 members each linked by videoconferencing devices at up to 6 rural outreach clinics. Multiple participants can be seen by the clinician and participants can also see each other from different sites. ST is identical in length and time of sessions (8 one-hour sessions), but is more passive and less instructional than MAAT. Design. Breast cancer survivors will be randomized to either MAAT-V or ST. Survivors will be evaluated for self-reported impact of cognitive problems on quality of life, anxiety about cognitive problems, functional wellbeing, and on brief telephone-based neuropsychological tests of memory at 3 time points: pre-treatment, post-treatment and 2-month follow-up. Statistical analyses will consist of a 2 X 3 (baseline, post-treatment and follow-up), repeated measures analysis of variance with dependent measures listed above and a planned comparison approach to reduce risk of spurious findings. Type of chemotherapy, age, education, estimated IQ, fatigue, and other factors will be evaluated as possible covariates. Clinically significant change on outcome measures will be evaluated using the reliable change index (RCI). Satisfaction will be assessed with 0-8 Likert-type ratings. A qualitative analysis of 20 randomly selected participants will be completed to assess practicality of MAAT-V. Significance. Study results will advance knowledge of the feasibility of MAAT delivered through videoconference to improve breast cancer survivor quality of life, especially in rural, underserved areas.

描述（由申请人提供）：与癌症化学疗法相关的认知功能障碍可能会对癌症幸存者的生活质量产生巨大影响，并被认为是日益增长的生存问题。但是，相关的认知变化的病因尚不清楚，目前尚无广泛验证的治疗方法。 PI正在开发短暂的认知行为疗法（CBT；记忆和注意力适应训练； MAAT），旨在帮助癌症幸存者自我管理并应对日常记忆力失败。初步研究表明，MAAT可能会改善自我报告的每日认知失败和言语记忆表现，而幸存者则以强烈的满意度对其进行评分，但需要更多的研究。拟议的研究旨在评估通过视频会议技术提供的修订版和更激烈的MAAT（从4次访问增加到8次访问），以通过化学疗法相关的认知投诉 - 具有地理位置和生存服务的成本障碍来帮助农村乳腺癌幸存者。将MAAT与视频会议支持疗法（ST）进行比较。因此，本研究旨在评估通过视频会议技术提供的MAAT的可行性。参与者。 48名因与化学疗法相关的认知障碍治疗的妇女接受了第一阶段，II或IIIA乳腺癌，过去6个月以前的化学疗法以及没有其他神经系统或精神病学历史，或者未接受的焦虑或情绪障碍。干涉。 MAAT-VIDEO（MAAT-V）将由每周的8个小时会议组成，由2-4个成员组成，每个会员由最多6个农村外展诊所的视频会议设备链接。临床医生可以看到多个参与者，参与者也可以从不同的站点彼此见面。 ST的长度和时间相同（8个小时的会议），但比MAAT更具被动性和教学较少。设计。乳腺癌幸存者将被随机分为MAAT-V或ST。将评估幸存者的认知问题对生活质量，对认知问题的焦虑，功能福祉的焦虑以及在3个时间点进行记忆的简短神经心理测试的自我报告的影响：治疗前，治疗后和2个月的随访。统计分析将包括2 x 3（基线，治疗后和随访），重复测量方差分析，以及上面列出的依赖度量以及降低虚假发现风险的计划比较方法。将评估化学疗法，年龄，教育，估计的智商，疲劳和其他因素的类型。将使用可靠的变化指数（RCI）评估临床上显着的结果度量。满意度将通过0-8 Likert型评级进行评估。将完成对20名随机选择参与者的定性分析，以评估MAAT-V的实用性。意义。研究结果将提高人们通过视频会议提供的MAAT的可行性，以改善乳腺癌幸存者的生活质量，尤其是在农村服务不足的地区。