Child Coping during Pediatric Oncology Treatment Procedures

儿童在小儿肿瘤治疗过程中的应对

• 批准号: 7891356
• 负责人: Felicity Harper
• 金额: $ 7.6万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-10 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7891356
• 关键词: Address; Affect; Aftercare; Aggressive behavior; Anxiety; Archives; Behavior; Behavioral; Cancer Patient; Child; Child Behavior; Clinic Visits; Code; Communication; Coping Behavior; Data; Data Analyses; Development; Distress; Family; Funding; Future; Goals; Grant; Intervention; Long Term Survivorship; Malignant Childhood Neoplasm; Malignant Neoplasms; Mediating; Medical; Mental Depression; Nurses; Outcome; Parents; Patient Self-Report; Pediatric Oncology; Physicians; Plant Roots; Practice Guidelines; Procedures; Process; Quality of life; Reaction; Research; Risk; Risk Assessment; Role; Spinal Puncture; Survivors; System; Temperament; Testing; Time; Training; Variant; Video Recording; Visit; abstracting; base; cancer therapy; coping; effective intervention; experience; improved; indexing; psychosocial; public health relevance; resilience; response; stressor; survivorship; therapy design; therapy development; trait

DESCRIPTION (provided by applicant): Causes and Consequences of Child Coping during Pediatric Oncology Treatment Episodes: A Secondary Data Analysis ABSTRACT Many pediatric cancer patients experience serious psychosocial problems during and after treatment. Designing interventions to reduce these problems and improve the quality of long-term survivorship requires understanding the origins of stressors underlying these psychosocial problems. Treatment episodes (defined as the time before, during, and immediately following treatment procedures) are one of the most stressful aspects of pediatric cancer, and child long-term outcomes are rooted in the treatment experience. As a result, children's negative responses to treatment episodes may place them at greater risk for negative psychosocial outcomes after treatment. Findings from our previous NIH-funded research show that differences in parent and child attributes (i.e., trait affect, temperament, resilience), child behavior problems (i.e., anxiety, depression, somatic problems, aggression), and parent state affect and communication are associated with children's global ratings of distress during treatment episodes. However, little is known about the role of child coping behaviors during these episodes and how these behaviors might mediate these relationships. Our long-term goal is to understand how factors that exist prior to treatment episodes and interpersonal processes during episodes influence child coping, and in turn, child responses to treatment episodes (i.e., distress behaviors during episodes and quality of life post-episode). Therefore, our primary objective in the proposed study is to extend our previous research with a secondary analysis of previously video-recorded pediatric oncology treatment episodes (and related parent and child variables) to achieve the following aims: Aim #1: Further develop and refine a coding system to systematically observe and analyze child coping and distress behaviors during treatment episodes Aim #2: Apply this coding system to an existing archive of video-recorded pediatric oncology treatment episodes that include parents and children (N = 41) Aim #3: Explore and empirically test relationships between observational ratings of child coping behaviors during treatment episodes and: (a) parent and child dispositional attributes, (b) child behavior problems, (c) parent communication and affect during episodes, and (d) child distress during treatment episodes (i.e., observed ratings of specific distress behaviors; global ratings by parents, nurses, children; and observed global ratings by trained coders) and child quality of life after treatment episodes. Our overarching research goal is to develop effective interventions to reduce distress and improve quality of life for pediatric cancer patients. This goal requires an improved understanding of the causes and consequences of children's coping during treatment episodes. We expect our proposed research to provide direct, empirical evidence to inform the development of future interventions to enhance child coping, thereby reducing distress during episodes and improving the long-term quality of life for survivors and their families. PUBLIC HEALTH RELEVANCE: Project Narrative Previous research shows that children's cancer treatment experiences are a factor in their long-term well- being and quality of survivorship. This study seeks to better understand the causes and the consequences of differences in children's coping during treatment episodes. We will refine and apply an observational coding system to an archive of previously collected video-recordings of child treatment visits and then analyze the relationships between child coping behaviors and several child and parent factors prior to, during, and following the treatment. We expect the findings of our proposed research to provide direct evidence to inform the development of interventions to facilitate children's positive coping during treatment episodes, thereby reducing their distress during episodes and improving the long-term quality of life for survivors and their families.

描述（由申请人提供）：儿科肿瘤治疗期间儿童应对的原因和后果：二次数据分析 摘要 许多儿科癌症患者在治疗期间和治疗后都会经历严重的社会心理问题。设计干预措施来减少这些问题并提高长期生存的质量需要了解这些心理社会问题背后的压力源的根源。治疗阶段（定义为治疗程序之前、期间和之后的时间）是儿科癌症压力最大的方面之一，儿童的长期结果植根于治疗经历。因此，儿童对治疗事件的负面反应可能会使他们在治疗后面临更大的负面心理社会结果的风险。我们之前 NIH 资助的研究结果表明，父母和孩子属性（即特质影响、气质、复原力）、儿童行为问题（即焦虑、抑郁、躯体问题、攻击性）以及父母状态影响和沟通的差异与儿童在治疗期间的总体痛苦评级相关。然而，人们对儿童应对行为在这些事件中的作用以及这些行为如何调解这些关系知之甚少。我们的长期目标是了解治疗发作前存在的因素和治疗期间的人际交往过程如何影响儿童的应对方式，进而影响儿童对治疗发作的反应（即发作期间的痛苦行为和发作后的生活质量）。因此，我们在拟议研究中的主要目标是通过对先前视频记录的儿科肿瘤治疗事件（以及相关的父母和儿童变量）进行二次分析来扩展我们之前的研究，以实现以下目标： 目标＃1：进一步开发和完善一个编码系统，用于系统地观察和分析治疗期间儿童的应对和困扰行为 目标 2：将此编码系统应用于包括父母和儿童在内的儿科肿瘤治疗视频记录的现有档案 (N = 41) 目标 3：探索并实证测试治疗期间儿童应对行为的观察评级与：（a）父母和儿童性格属性，（b）儿童行为问题，（c）治疗期间父母沟通和影响，以及（d）治疗期间儿童困扰之间的关系治疗事件（即观察到的特定痛苦行为的评级；父母、护士、儿童的总体评级；以及训练有素的编码员观察到的总体评级）和治疗事件后儿童的生活质量。我们的总体研究目标是开发有效的干预措施，以减少儿科癌症患者的痛苦并提高其生活质量。这一目标需要更好地了解儿童在治疗期间应对的原因和后果。我们希望我们提出的研究能够提供直接的经验证据，为未来增强儿童应对能力的干预措施的制定提供信息，从而减少发作期间的痛苦并改善幸存者及其家人的长期生活质量。 公共健康相关性：项目叙述 先前的研究表明，儿童的癌症治疗经历是影响他们长期福祉和生存质量的一个因素。这项研究旨在更好地了解治疗期间儿童应对差异的原因和后果。我们将完善观察编码系统并将其应用于以前收集的儿童治疗访问视频记录的档案中，然后分析儿童应对行为与治疗之前、期间和之后的几个儿童和家长因素之间的关系。我们希望我们拟议的研究结果能够提供直接证据，为制定干预措施提供信息，以促进儿童在治疗期间的积极应对，从而减少他们在治疗期间的痛苦并改善幸存者及其家人的长期生活质量。