A Patient-Caregiver Behavioral Intervention for Older Adults with Cancer and Mild Cognitive Impairment

针对患有癌症和轻度认知障碍的老年人的患者护理人员行为干预

• 批准号: 10693808
• 负责人: Katherine Ramos
• 金额: $ 16.19万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10693808
• 关键词: Address; Adult; Anxiety; Area; Award; Behavior Therapy; Behavioral Model; Behavioral Sciences; Biometry; Cancer Burden; Caregivers; Caring; Client satisfaction; Cognitive Therapy; Cognitive deficits; Communication; Communication Programs; Communities; Complex; Coping Skills; Coupled; Data; Data Collection; Development; Diagnosis; Dissemination and Implementation; Distress; Division of Cancer Control and Population Sciences; Educational process of instructing; Elderly; Elements; Face; Family; Family Caregiver; Feedback; Frequencies; Future; Geriatric Psychiatry; Geriatrics; Goals; Health Personnel; Health Psychology; Health Services; Healthcare; Impairment; Individual; International; Intervention; Interview; Judgment; K-Series Research Career Programs; Knowledge; Length; Life; Life Experience; Literature; Malignant Neoplasms; Manuals; Measures; Mediation; Medical; Memory; Mental Depression; Mental Health; Mentors; Mentorship; Minority; Mission; Modification; Older Population; Oncology; Outcome; Palliative Care; Participant; Patient Care; Patients; Personal Satisfaction; Persons; Pilot Projects; Population; Populations at Risk; Positioning Attribute; Procedures; Program Development; Provider; Public Health; Qualitative Research; Quality of life; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Research Project Grants; Research Training; Resources; Risk; Scientific Advances and Accomplishments; Secure; Self Management; Signal Transduction; Structure; Symptoms; Tablets; Teacher Professional Development; Testing; Thinking; Training; United States National Institutes of Health; Work; acceptability and feasibility; anxiety symptoms; arm; cancer care; cancer diagnosis; cancer therapy; care providers; career development; chemobrain; clinical practice; comorbidity; coping; depressive symptoms; design; evaluation/testing; experience; follow-up; formative assessment; human old age (65+); implementation science; improved; innovation; interest; intervention refinement; loved ones; mild cognitive impairment; negative affect; novel; participant interview; personalized intervention; pilot test; primary outcome; programs; psychological distress; psychological outcomes; psychosocial; recruit; satisfaction; secondary outcome; skills; skills training; theories; therapy design; therapy development; videoconference

Project Summary/Abstract: This proposal presents a five-year research career development program focused on the study and development of a dyadic behavioral intervention to improve distress (e.g., depression and anxiety) and communication for older adults coping with cancer and pre-existing mild cognitive impairment (MCI); and for their family caregiver. While MCI in older adults does not overtly impede function, it can manifest under conditions of distress. Close to 50% of older adults with co-occurring cancer and MCI are at vulnerable risk to experience high levels of distress (e.g., depression and anxiety) which can negatively affect their sense of independence, communication of what matters most for their care, and overall quality of life. Their family caregivers may experience equal or even higher levels of distress when managing their loved one’s cancer symptoms and cognitive deficits. Surprisingly, a large gap exists in the development of dyadic behavioral interventions to treat distress and improve communication to address both patient and caregiver needs. The proposed project seeks to address a major gap in the literature and clinical practice for older adults with co- occurring cancer and MCI, and their family caregiver. The overall objective of this K08 proposal is to develop a dyadic intervention (created by Dr. Ramos, titled: COPE+), informed by her previous work in individually based interventions for oncology and palliative care populations, and pilot COPE+ as a novel patient-caregiver dyadic intervention consisting of distress coping skills, and newly include communication-skills training. The proposed mentored research activities for this K08 award are to refine and pilot test the dyadic intervention informed by Family Self-Management Theory. Mentored research training will occur in the context of a focused research project with three aims: 1) To refine the COPE+ intervention using interviews with patients, caregivers and providers. 2) To finalize the intervention and study procedures through user testing. 3) To examine the feasibility and acceptability of COPE+. This K08 application is consistent with NCI’s mission to advance scientific knowledge of the unique needs of people living with cancer and aligns with the NCI’s Division of Cancer Control and Population Sciences in helping reduce the burden of the cancer experience via use of behavioral intervention approaches to enhance quality of life. To become an independent researcher in the field of geriatric oncology and mental health, Dr. Ramos requires additional training in: 1) qualitative research and geriatric oncology; 2) recruitment, engagement, and retention of older adults with cancer and MCI, and their family caregivers; 3) design, develop, and pilot dyadic behavioral interventions; and 4) develop expertise in dissemination and implementation. Dr. Ramos’ intensive training plan coupled with a team of internationally recognized researchers in health psychology, geriatrics, health services/implementation science, underrepresented faculty development, and biostatistics will position her to be a geropsychology leader studying and addressing mental health in older adult cancer populations and co-occurring MCI.

项目摘要/摘要：该提案提出了一个为期五年的研究职业发展计划，重点关注 研究和开发二元行为干预措施以改善痛苦（例如抑郁症和抑郁症） 焦虑）和应对癌症和已有轻度认知障碍（MCI）的老年人的沟通； 对于他们的家庭照顾者来说，虽然老年人的 MCI 不会过度妨碍功能，但它可能会在以下情况下表现出来。 近 50% 的同时患有癌症和 MCI 的老年人面临着罹患抑郁症的风险。 经历高度的痛苦（例如抑郁和焦虑），这会对他们的感觉产生负面影响 独立性、沟通对他们的护理最重要的事情以及他们的家庭的整体生活质量。 护理人员在治疗亲人的癌症时可能会经历同等甚至更高程度的痛苦 令人惊讶的是，二元行为的发展存在很大差距。 治疗痛苦和改善沟通的干预措施，以满足患者和护理人员的需求。 拟议的项目旨在解决患有共同疾病的老年人的文献和临床实践中的主要差距 患有癌症和 MCI 的人及其家庭护理人员 本 K08 提案的总体目标是制定一个 二元干预（由拉莫斯博士创建，标题为：COPE+），借鉴了她之前基于个人的工作 针对肿瘤学和姑息治疗人群的干预措施，以及试点 COPE+ 作为新型患者-护理人员二元体系 干预措施包括应对压力的技能，新近还包括沟通技能培训。 该 K08 奖项的指导研究活动是完善和试点测试二元干预 家庭自我管理理论指导研究培训将在重点研究的背景下进行。 该项目具有三个目标：1) 通过对患者、护理人员和患者的访谈来完善 COPE+ 干预措施 2) 通过用户测试最终确定干预和研究程序。 COPE+ 的可接受性和可接受性 本 K08 申请符合 NCI 科学进步的使命。 了解癌症患者的独特需求，并与 NCI 癌症控制部门保持一致 和人口科学通过行为干预帮助减轻癌症经历的负担 提高生活质量的方法。成为老年肿瘤学领域的独立研究员。 和心理健康方面，拉莫斯博士需要以下方面的额外培训：1) 定性研究和老年肿瘤学；2) 招募、参与和保留患有癌症和 MCI 的老年人及其家庭护理人员 3) 设计、开发和试点二元行为干预措施；4) 发展传播和推广方面的专业知识 拉莫斯博士的强化培训计划以及国际公认的研究人员团队的实施。 健康心理学、老年病学、卫生服务/实施科学、代表性不足的教师发展、 生物统计学将使她成为研究和解决老年人心理健康问题的老年心理学领导者 成人癌症人群和同时发生的 MCI。

项目成果

Concurrent and Prospective Associations Between Communicated Emotional Arousal and Adjustment Among Couples Coping With Cancer.

应对癌症的夫妻中交流情绪唤起与调整之间的同步和前瞻性关联。

• DOI: 10.1093/abm/kaad017
• 发表时间: 2023
• 期刊: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine
• 作者: Weber,DanielleM;Baucom,BrianRW;Baucom,DonaldH;Fischer,MelanieS;Ramos,Katherine;Romano,JoanM;Porter,LauraS;Langer,ShelbyL
• 通讯作者: Langer,ShelbyL

Top Ten Tips Palliative Care Clinicians Should Know About Behavioral Pain Management for Persistent Pain.

姑息治疗临床医生应该了解针对持续性疼痛的行为疼痛管理的十大技巧。

• DOI: 10.1089/jpm.2022.0571
• 发表时间: 2023
• 期刊: Journal of palliative medicine
• 影响因子: 2.8
• 作者: Gerhart,James;Ramos,Katherine;Porter,LauraS;Ravyts,Scott;Malhotra,Sonia;Mossman,Brenna;EatonEngland,Ashley;Alonzi,Sarah;Peyser,Tristen;Kim,Seowoo;O'Mahony,Sean;Burns,JohnW;Hoerger,Michael
• 通讯作者: Hoerger,Michael

Knowledge, goals, and misperceptions about palliative care in adults with chronic disease or cancer.

关于患有慢性疾病或癌症的成人姑息治疗的知识、目标和误解。

• DOI: 10.1017/s1478951523001141
• 发表时间: 2023
• 期刊: Palliative & supportive care
• 影响因子: 2.2
• 作者: Ramos,Katherine;Kaufman,BrystanaG;Winger,JosephG;Boggins,Abby;VanHoutven,CourtneyH;Porter,LauraS;Hastings,SNicole
• 通讯作者: Hastings,SNicole

Attachment in Couples Coping with Cancer: Associations with Observed Communication and Long-Term Health.

• DOI: 10.3390/ijerph20075249
• 发表时间: 2023-03-24
• 期刊: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
• 作者: Ramos, Katherine;Leo, Karena;Porter, Laura S;Romano, Joan M;Baucom, Brian R W;Langer, Shelby L
• 通讯作者: Langer, Shelby L