EHealth Mindful Movement and Breathing to Improve Gynecologic Cancer Surgery Outcomes

EHealth 正念运动和呼吸可改善妇科癌症手术结果

• 批准号: 9752318
• 负责人: Stephanie Jean Sohl
• 金额: $ 27.13万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9752318
• 关键词: Abdomen; Acute; Acute Pain; Address; Adherence; Adopted; Adult; Affect; Affective; Aftercare; Analgesics; Breathing; Breathing Exercises; Cancer Patient; Cancer Survivor; Chronic; Clinical Informatics; Combined Modality Therapy; Complementary Health; Control Groups; Data; Deep Vein Thrombosis; Diagnosis; Dimensions; Distress; Elements; Enrollment; Face; Feasibility Studies; Future; Goals; Health Personnel; Hospitalization; Hypnosis; Ileus; Integrative Medicine; Intervention; Investigation; Length of Stay; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Manuals; Meditation; Methodological Studies; Methods; Mind-Body Intervention; Movement; Nonpharmacologic Therapy; Operative Surgical Procedures; Outcome; Pain; Pain management; Participant; Patients; Perioperative; Persons; Pharmacology; Phase; Physiological; Population; Populations at Risk; Postoperative Pain; Postoperative Period; Prevalence; Procedures; Public Health; Quality of life; Randomized Clinical Trials; Randomized Controlled Trials; Recovery; Relaxation; Reporting; Research; Schedule; Sensory; Sleep disturbances; Subgroup; Surgical complication; Symptoms; Testing; Time; Travel; Woman; Work; Wound Healing; Yoga; associated symptom; attentional control; body-mind; cancer surgery; chronic pain; eHealth; effective intervention; efficacy trial; experience; field study; implementation strategy; improved; innovation; intervention cost; malignant breast neoplasm; mindfulness; multimodality; non-opioid analgesic; operation; pain reduction; preference; prevent; psychologic; psychological distress; recruit; retention rate; surgery outcome; symptom management; treatment as usual; treatment guidelines

PROJECT SUMMARY Improved management of acute perioperative pain and co-morbid symptoms (i.e., sleep disturbances, psychological distress) among women undergoing surgery for suspected gynecologic malignancies may proactively reach an at-risk population and reduce the overall burden of chronic pain. In fact, patients who are women, have surgery, and are diagnosed with cancer are among the subgroups most vulnerable to chronic pain. Mind-body interventions are commonly sought after nonpharmacological approaches for pain and other symptom management, particularly in cancer patients. Yoga is a multimodal mind-body intervention that may optimally address pain and co-morbid symptoms through psychological and physiological mechanisms not affected by pain medication. Yoga has a potential advantage over other nonpharmacological interventions because of its multiple components that also support the usual care goals of encouraging mobility and deep breathing and thus may improve additional surgical complications (e.g., ileus, deep venous thrombosis). The proposed Mindful Movement and Breathing (MMB) brief yoga intervention is innovative because it adapts key elements of a longer intervention to a short-term format that can be implemented during the acute perioperative timeframe. The proposed research will adapt the already developed in-person MMB intervention and in-person attention control (AC) to an eHealth format (Aim I). Aim II will field test implementation strategies for the resulting eMMB, and Aim III will determine feasibility and acceptability of the eMMB and AC to reduce pain and other surgical outcomes through an exploratory randomized clinical trial among women undergoing surgery for suspected gynecologic malignancies. Developing and assessing the feasibility of an AC group in an eHealth intervention will be instrumental for the next stages of the proposed research and may be applicable to the study of mind-body interventions more broadly. Following this feasibility study, we will conduct a fully- powered investigation of the efficacy of the optimized eMMB for reducing pain, sleep disturbance, and psychological distress after gynecologic cancer surgery. The brevity and accessibility of the intervention, and the increasing popularity of yoga, make the eMMB a strong candidate for future dissemination. If we demonstrate efficacy of the eMMB for improving surgical outcomes of women who undergo surgery for a suspected gynecologic malignancy, results may be generalizable to other perioperative patients and have important public health implications for reducing the growing population affected by chronic pain. The proposed research addresses priorities outlined by the National Center for Complementary and Integrative Health (i.e., investigates a mind-body approach for symptom management).

项目概要 改善急性围手术期疼痛和共病症状（即睡眠障碍、 接受疑似妇科恶性肿瘤手术的女性可能会感到心理困扰 主动接触高危人群并减轻慢性疼痛的总体负担。事实上，患有这些疾病的患者 女性、接受手术和被诊断患有癌症是最容易患慢性病的亚群 疼痛。通常寻求针对疼痛和其他疾病的非药物方法进行身心干预 症状管理，尤其是癌症患者。瑜伽是一种多模式的身心干预，可以 通过心理和生理机制最佳地解决疼痛和共病症状 受止痛药的影响。瑜伽比其他非药物干预措施具有潜在优势 因为它的多个组成部分也支持鼓励活动和深度的常规护理目标 呼吸，因此可以改善其他手术并发症（例如肠梗阻、深静脉血栓形成）。这 拟议的正念运动和呼吸（MMB）简短瑜伽干预措施是创新的，因为它适应了关键 可以在紧急情况下实施的短期干预的长期干预的要素 围手术期时间范围。拟议的研究将采用已经开发的面对面 MMB 干预措施 以及电子医疗格式的现场注意力控制 (AC)（目标 I）。目标II将实地测试实施策略 对于最终的 eMMB，Aim III 将确定 eMMB 和 AC 的可行性和可接受性，以减少 通过一项在接受手术的女性中进行的探索性随机临床试验，了解疼痛和其他手术结果 疑似妇科恶性肿瘤的手术。制定并评估 AC 小组的可行性 电子健康干预将有助于拟议研究的下一阶段，并可能适用于 更广泛地研究身心干预。在此可行性研究之后，我们将进行全面的 对优化的 eMMB 在减轻疼痛、睡眠障碍和 妇科癌症手术后的心理困扰。干预的简洁性和可及性，以及 瑜伽的日益普及，使 eMMB 成为未来传播的有力候选者。如果我们 证明 eMMB 对于改善接受手术的女性的手术结果的功效 疑似妇科恶性肿瘤，结果可能适用于其他围手术期患者，并且 对于减少日益增长的慢性疼痛影响的人口具有重要的公共卫生影响。拟议的 研究解决了国家补充和综合健康中心概述的优先事项（即， 研究了症状管理的身心方法）。