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.

项目概要 改善女性急性疼痛、心理困扰和其他手术结果的管理 接受疑似妇科恶性肿瘤手术将主动接触到易患妇科恶性肿瘤的人群 发展为慢性疼痛。解决多个生物行为维度的非药物干预措施 疼痛（例如认知、行为）可能最有效地防止转变为慢性疼痛。瑜伽 （冥想、运动和呼吸）是一种身心干预，可以减少疼痛、心理困扰、 和睡眠障碍，并改善身体机能。瑜伽比其他瑜伽有潜在的优势 围手术期非药物干预，因为额外的成分也支持多种 术后常规护理的目标（例如术后早期活动、鼓励深呼吸）以及 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 可以通过多种方式最佳地改善疼痛、心理困扰和其他手术治疗结果 生物行为机制。然而，有限的严格研究评估了与 手术护理。拟议的电子健康正念运动和呼吸 (eMMB) 具有创新性，因为它适应 瑜伽的核心组成部分，旨在消除参与的主要障碍并减轻 从急性疼痛转变为慢性疼痛。我们建议对 eMMB 进行一项随机对照试验，比较 对 122 名因疑似妇科疾病接受手术的女性进行移情注意控制 (AC) 恶性肿瘤。我们的目标是确定 eMMB 对于改善疼痛和其他手术结果的功效（目标 1)，并检查 eMMB 对拟议的近端生物行为结果的影响（目标 2）。我们也会 与主要利益相关者（n=18-24；患者、支持者、提供者、瑜伽 讲师）评估在临床中可持续实施 eMMB 的障碍或促进因素 护理（目标 3）。了解这些因素将为未来研究中测试的实施策略提供信息。 总之，eMMB 在围手术期到达患者，并有可能预防 通过低成本干预从急性疼痛转变为慢性疼痛。的简洁性和可访问性 干预以及瑜伽的日益普及，使 eMMB 成为未来实施的有力候选者。 这项针对接受妇科恶性肿瘤手术的女性的研究结果可推广到 其他外科手术，因此对于减少不断增长的感染具有重要的公共卫生影响 受慢性疼痛影响的人群。拟议的研究与科学机遇相一致 减轻国家癌症研究所强调的癌症治疗的长期影响。