Role of Emotional Processing in Art Therapy for Breast Cancer Palliative Care Patients: A Mechanistic Study

情绪处理在乳腺癌姑息治疗患者艺术治疗中的作用：机制研究

• 批准号: 9794138
• 负责人: Johanna Czamanski-Cohen
• 金额: $ 32.45万
• 依托单位: UNIVERSITY OF HAIFA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-26 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9794138
• 关键词: Adherence; Affect; Anti-Cholinergics; Anti-inflammatory; Antiinflammatory Effect; Arabs; Arts; Awareness; Breast Cancer Patient; Breast Cancer survivor; Breast Cancer therapy; Cancer Survivor; Communication; Cultural Backgrounds; Diagnosis; Distress; Emotional; Emotions; Ensure; Ethnic Origin; Fatigue; Frequencies; Future; Health; Healthcare; Hospitalization; Hour; Individual; Inflammatory; Israel; Malignant Neoplasms; Measures; Mediating; Mental Depression; Minority; Outcome; Pain; Palliative Care; Participant; Patient Care; Process; Psychophysiology; Psychotherapy; Quality of life; Randomized; Randomized Controlled Trials; Reporting; Research; Resolution; Rest; Role; Sample Size; Shapes; Site; Symptoms; Testing; Therapeutic; Therapeutic Intervention; Time; United States; Visual; Woman; Work; base; breast cancer diagnosis; cancer diagnosis; cancer palliative treatment; cancer therapy; coping; cost; cytokine; depressive symptoms; design; ethnic minority population; experience; follower of religion Jewish; group intervention; heart rate variability; improved; malignant breast neoplasm; persistent symptom; programs; psychological symptom; recruit; response; showing emotion; social norm; study population; symptom management; symptomatic improvement; therapy design

ABSTRACT Approximately one-third of women coping with breast cancer experience persistent symptoms of depression, pain and fatigue, which are not normative and are difficult to treat. Emotion approach coping, including awareness, acceptance and expression of emotions is related to more rapid resolution of depressive symptoms and improved health outcomes in breast cancer survivors. Since expression of emotion is inconsistent with social norms in some ethnic minorities, specifically those from a more traditional background, BC survivors from these ethno-cultural minorities are less likely to seek opportunities for emotional expression and support. Art Therapy is a form of psychotherapy that uses visual art-making as a form of expression and communication within a safe and supportive relationship, in a therapeutic setting. Art Therapy is documented in cancer settings to alleviate psychological symptoms and to reduce physical complaints. BC survivors have reported that art-making increased access to emotional content and its expression. Because Art Therapy provides the opportunity for indirect expression, it may be particularly potent with individuals from traditional and collectivist ethno-cultures. The purpose of this study is to examine emotional processing and cholinergic anti- inflammatory processes through which an AT intervention may reduce depression, pain and fatigue. To examine these emotional processing and cholinergic anti-inflammatory mechanisms, we have designed a randomized controlled study with careful controls. Responsive to PAR-14-294 on Arts-Based Approaches in Palliative Care for Symptom management, the research seeks to accomplish: AIM 1: To examine two mechanisms: 1) emotional processing and 2) cholinergic anti-inflammatory processes, through which Art Therapy reduces depression, pain and fatigue in Jewish and Arab BC survivors. Hypothesis: Participants in Art Therapy (vs sham Art Therapy (Mandala)) will experience greater increases in emotion processing (awareness, acceptance and expression), resting HRV, and regulatory cytokine expression as well as a greater decrease in pro-inflammatory cytokine expression: which in turn will mediate the effect of Art Therapy on depression, pain and fatigue. AIM 2: To examine ethno-cultural differences in the effect of Art Therapy in women from a traditional collectivist ethno-cultural background, compared to women from a more individualist western ethno-cultural background. Hypothesis: Individuals from a traditional collectivist ethno-cultural group will demonstrate a more prominent response to the Art Therapy intervention, compared to women in the more individualist western ethno-cultural group, beyond differences in traditional values. We will conduct a randomized controlled trial of 120 Jewish and 120 Arab women diagnosed with breast cancer diagnosed within the last year, recruited in Israel and randomized to undergo an 8-week program of AT compared to sham Art Therapy.

抽象的 大约三分之一患有乳腺癌的女性会出现持续的抑郁症状， 疼痛和疲劳，这些不正常并且难以治疗。情绪应对方法包括 情绪的认知、接受和表达与抑郁症状的更快缓解有关 并改善乳腺癌幸存者的健康状况。由于情感的表达与社交不相符 一些少数民族的规范，特别是那些来自更传统背景的人，不列颠哥伦比亚省的幸存者 民族文化少数群体不太可能寻求情感表达和支持的机会。 艺术治疗是一种心理治疗形式，它使用视觉艺术创作作为表达形式和 在治疗环境中，在安全和支持性关系中进行沟通。艺术治疗记录于 癌症环境可减轻心理症状并减少身体不适。 BC省的幸存者有 报道称，艺术创作增加了人们获取情感内容及其表达的机会。因为艺术治疗 提供了间接表达的机会，对于来自传统和传统文化的个人来说可能特别有效 集体主义民族文化。本研究的目的是检查情绪处理和胆碱能抗 AT 干预可以通过炎症过程减轻抑郁、疼痛和疲劳。 为了检查这些情绪处理和胆碱能抗炎机制，我们有 设计了一项经过仔细控制的随机对照研究。响应基于艺术的 PAR-14-294 该研究旨在通过姑息治疗症状管理方法来实现： 目标 1：检查两种机制：1) 情绪处理和 2) 胆碱能抗炎过程， 通过艺术疗法减轻犹太和阿拉伯公元前幸存者的抑郁、疼痛和疲劳。 假设：艺术治疗（与假艺术治疗（曼陀罗）相比）的参与者将经历更大的增加 情绪处理（意识、接受和表达）、静息 HRV 和调节性细胞因子表达 以及促炎细胞因子表达的更大减少：这反过来又会介导 针对抑郁、疼痛和疲劳的艺术疗法。 目标 2：从传统集体主义者的角度审视艺术治疗对女性的影响的民族文化差异 与来自更个人主义的西方民族文化背景的女性相比。 假设：来自传统集体主义民族文化群体的个体将表现出更突出的 与更个人主义的西方民族文化中的女性相比，女性对艺术治疗干预的反应 群体，超越传统价值观的差异。 我们将对 120 名被诊断患有乳腺癌的犹太妇女和 120 名阿拉伯妇女进行随机对照试验 去年诊断出癌症，在以色列招募并随机接受为期 8 周的 AT 计划 与假艺术治疗相比。