Problem-Solving Therapy for Cancer Caregivers: A Randomized Clinical Trial in Outpatient Palliative Care

癌症护理人员的问题解决疗法：门诊姑息治疗的随机临床试验

基本信息

批准号：
10456106
负责人：
Karla Washington
金额：
$ 62.44万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-01 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10456106
关键词：
Address Adoption Adverse effects Ambulatory Care Facilities American Anxiety Attention Caregiver support Caregiver well-being Caregivers Caring Clinic Clinical Complex Control Groups Coupled Data Distress Effectiveness Emotional Event Evidence based intervention Family Family Caregiver Future Goals Growth Healthcare Hospitals Individual Inpatients Intervention Interview Life Literature Malignant Neoplasms Measures Mental Depression National Cancer Institute Oncology Outcome Outcome Measure Outpatients Palliative Care Patients Philosophy Pilot Projects Positioning Attribute Qualitative Methods Quality of life Randomized Randomized Clinical Trials Reporting Research Research Personnel Risk Rural Science Service provision Services Social Environment Testing Therapeutic Intervention United States Work attentional control base biopsychosocial cancer care cancer palliative treatment cancer therapy care providers caregiver interventions caregiving comparison group design evidence base experience family caregiving frontier group intervention health care service utilization improved meetings palliative preference problem solving therapy psychological distress psychosocial randomized trial recruit response service gap stressor symptomatology treatment as usual

项目摘要

ABSTRACT In recent decades, the primary setting for oncology treatment has shifted from the hospital inpatient unit to the outpatient clinic, leaving nearly 4.6 million family caregivers responsible for most of the day-to-day, round-the- clock cancer care provided in the United States. Cancer caregiving often occurs in a highly stressful emotional and social context, leaving caregivers vulnerable to significant, potentially long-lasting, adverse effects. Although palliative care teams are ideally positioned to help family caregivers cope with the numerous stressors they encounter, there is little evidence on which to base cancer caregiver support in the outpatient palliative care clinic. To address the pressing need for research on caregiver interventions in this setting, an interdisciplinary team of investigators will conduct a multisite, randomized trial of problem-solving therapy for family caregivers of individuals with cancer who are receiving outpatient palliative care. Potential barriers and facilitators to the adoption of problem-solving therapy in both rural and urban clinics will also be examined, resulting in a greater understanding of the context in which the therapy will ultimately be delivered if shown to be effective. The study’s specific aims are as follows: 1) determine the effect of problem-solving therapy on psychological distress among family caregivers of patients with cancer receiving outpatient palliative care; 2) measure the effect of problem-solving therapy on positive aspects of caregiving among family caregivers of patients with cancer receiving outpatient palliative care; and 3) identify potential barriers and facilitators to the adoption of problem-solving therapy for family caregivers in outpatient palliative oncology. At the conclusion of the study, investigators will broadly disseminate findings regarding the effectiveness of problem-solving therapy, and they will be well positioned to promote family caregiver wellbeing through the routine and sustained delivery of problem-solving therapy in outpatient palliative cancer care.

抽象的近几十年来，肿瘤治疗的主要环境已从医院住院单位转变为门诊诊所，剩下近460万家庭护理人员，负责每天的大部分时间美国提供的时钟癌症护理。癌症护理通常发生在高度压力的情绪中和社会背景，使护理人员容易受到重大，可能持久的不利影响。尽管姑息治疗团队的位置是帮助家庭护理人员应对众多他们遇到的压力源，几乎没有证据表明在门诊患者中为癌症照顾者提供支持姑息治疗诊所。为了满足在这种情况下对看护人干预措施的迫切需求，研究人员跨学科团队将对解决问题的疗法进行多站点，随机试验接受门诊姑息治疗的癌症患者的家庭护理人员。潜在的障碍和还将检查在粗糙和城市诊所采用问题解决疗法的促进者如果显示给有效。该研究的具体目的如下：1）确定解决问题的疗法对接受门诊姑息治疗的癌症患者家庭护理人员的心理困扰； 2）衡量解决问题疗法对家庭护理人员的积极方面的影响接受门诊姑息治疗的癌症患者； 3）确定潜在的障碍和促进者在门诊姑息肿瘤学中为家庭护理人员采用问题解决疗法。结束该研究，研究人员将广泛传播有关解决问题的有效性的发现治疗，他们将在常规中促进家庭护理人员的健康状况，并将在门诊姑息治疗癌症护理中持续提供问题的治疗。