REmotely-delivered Supportive Programs for Improving surgical pain and disTrEss (RESPITE)

用于改善手术疼痛和不适的远程支持计划 (RESPITE)

• 批准号: 10676844
• 负责人: Stephanie Jean Sohl
• 金额: $ 62.43万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-07 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10676844
• 关键词: Acute; Acute pain management; Address; Affect; Affective; Aftercare; Anxiety; Behavioral; Biological; Breathing; Cancer Patient; Cancer Survivor; Caring; Chronic; Clinical; Cognitive; Data; Diagnosis; Dimensions; Distress; Early Mobilizations; Exercise; Funding; Future; Goals; Guidelines; Gynecologic Oncology; Gynecologic Surgical Procedures; Health system; Heart Atrium; Hospitalization; Intention; Intervention; Interview; Length of Stay; Long-Term Effects; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Mediating; Meditation; Mental Depression; Mind-Body Intervention; Movement; National Cancer Institute; Operative Surgical Procedures; Outcome; Pain; Pain intensity; Pain management; Participant; Patients; Perioperative; Physical Function; Pilot Projects; Population; Postoperative Pain; Postoperative Period; Provider; Public Health; Quality of life; Randomized; Randomized, Controlled Trials; Recommendation; Recovery of Function; Relaxation; Reporting; Research; Research Infrastructure; Research Personnel; Sleep disturbances; Structure; Subgroup; Surgical Management; Surgical Oncology; Symptoms; Testing; Time; Travel; Vulnerable Populations; Woman; Yoga; acceptability and feasibility; associated symptom; attentional control; biobehavior; brief intervention; cancer surgery; cancer therapy; chronic pain; clinical care; clinical practice; depressive symptoms; eHealth; effectiveness/implementation study; efficacy evaluation; experience; future implementation; implementation determinants; implementation strategy; implementation study; improved; innovation; instructor; intervention cost; mindfulness; multimodality; opioid use; pain catastrophizing; pain chronification; pain reduction; pain symptom; prevent; primary outcome; programs; psychological distress; remote delivery; secondary outcome; surgery outcome; surgical pain; treatment as usual; treatment guidelines

PROJECT SUMMARY Improving the management of acute pain, psychological distress, and other surgical outcomes among women undergoing surgery for suspected gynecologic malignancies would proactively reach a population vulnerable to developing chronic pain. Non-pharmacological interventions that address multiple biobehavioral dimensions of pain (e.g., cognitive, behavioral) may be most effective at preventing the transition to chronic pain. Yoga (meditation, movements, and breathing) is a mind-body intervention that reduces pain, psychological distress, and sleep disturbances, and improves physical function. Yoga has a potential advantage over other perioperative non-pharmacological interventions because of additional components that also support multiple goals of postoperative usual care (e.g., early postoperative mobilization, encouraging deep breathing) and could help improve other surgical management outcomes (e.g., functional recovery, length of stay). Thus, yoga may optimally improve pain, psychological distress and other surgical management outcomes through multiple biobehavioral mechanisms. Yet, limited rigorous research has evaluated yoga delivered in coordination with surgical care. The proposed eHealth Mindful Movement and Breathing (eMMB) is innovative because it adapts the core components of yoga with the intention to remove key barriers to participation and mitigate the transition from acute to chronic pain. We propose to conduct a randomized controlled trial of eMMB compared to an empathic attention control (AC) among 122 women undergoing surgery for suspected gynecologic malignancies. We aim to determine the efficacy of eMMB for improving pain and other surgical outcomes (Aim 1), and to examine the effect of eMMB on proposed proximal biobehavioral outcomes (Aim 2). We will also conduct semi-structured interviews with key stakeholders (n=18-24; patients, champions, providers, yoga instructors) to assess factors that serve as barriers or facilitators to sustainably implementing eMMB in clinical care (Aim 3). Understanding these factors will inform implementation strategies to be tested in a future study. In summary, eMMB reaches patients during the perioperative period and has the potential to prevent the transition from acute to chronic pain with a low-cost intervention. The brevity and accessibility of the intervention, and the increasing popularity of yoga, make eMMB a strong candidate for future implementation. Results from this study in women undergoing surgery for gynecologic malignancies may be generalizable to other surgical procedures and thus have important public health implications for reducing the growing population affected by chronic pain. The proposed research is aligned with the scientific opportunity for mitigating long-term effects of cancer treatment highlighted by the National Cancer Institute.

项目摘要 改善女性急性疼痛，心理困扰和其他手术结果的管理 接受可疑的妇科恶性肿瘤的手术将主动达到容易受到伤害的人群 发展慢性疼痛。针对多个生物行为维度的非药理学干预措施 疼痛（例如认知，行为）可能最有效地防止过渡到慢性疼痛。瑜伽 （冥想，运动和呼吸）是一种思维体干预，可减轻疼痛，心理困扰， 和睡眠障碍，并改善身体机能。瑜伽比其他瑜伽具有潜在的优势 围手术期非药物干预措施，因为其他组件也支持多个 术后常规护理的目标（例如，术后早期动员，鼓励深呼吸）和 可以帮助改善其他手术管理结果（例如功能恢复，住院时间）。因此，瑜伽 通过多个 生物行为机制。然而，有限的严格研究评估了与 手术护理。拟议的eHealth注意运动和呼吸（EMMB）具有创新性，因为它适应 瑜伽的核心组成部分，目的是消除参与的关键障碍并减轻 从急性到慢性疼痛的过渡。我们建议进行EMMB的随机对照试验 在122名接受手术的妇女的妇科手术中，共同注意力控制（AC） 恶性肿瘤。我们旨在确定EMMB对改善疼痛和其他手术结果的功效（AIM 1），并检查EMMB对拟议近端生物行为结果的影响（AIM 2）。我们也会 与主要利益相关者进行半结构化访谈（n = 18-24；患者，冠军，提供者，瑜伽 讲师）评估作为障碍或促进者可持续实施EMMB的因素 护理（目标3）。了解这些因素将为实施策略提供信息，以在未来的研究中进行测试。 总而言之，EMMB在围手术期间接触患者，并有可能预防 通过低成本干预，从急性到慢性疼痛的过渡。简洁和可访问性 干预以及瑜伽的日益普及，使EMMB成为未来实施的有力候选人。 这项研究的结果是接受妇科恶性肿瘤手术的妇女可能是可以推广的 其他外科手术程序，因此对减少增长的重要公共卫生影响 受慢性疼痛影响的人群。拟议的研究与科学机会保持一致 国家癌症研究所强调的癌症治疗的长期影响。