A Multimethod Approach to Understanding the Biopsychosocial Underpinnings of Chronic Cancer Pain

了解慢性癌痛的生物心理社会基础的多种方法

• 批准号: 10438557
• 负责人: Katie Fitzgerald Jones
• 金额: $ 1.16万
• 依托单位: BOSTON COLLEGE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-18 至 2022-10-04
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10438557
• 关键词: Achievement; Acute; Award; Awareness; Biological; Biological Factors; Biological Models; Cancer Etiology; Cancer Pain Management; Cancer Survivor; Chronic Cancer Pain; Clinical; Cognitive Therapy; Combined Modality Therapy; Complex; Development; Distress; Early Diagnosis; Early treatment; Fellowship; Fright; Future; General Population; Goals; Growth; Health; Individual; Intervention; Knowledge; Literature; Malignant Neoplasms; Mentors; Methodology; Mission; Modeling; National Institute of Nursing Research; Nature; Nurses; Operative Surgical Procedures; Opioid; Pain; Pain Research; Pain interference; Pain management; Persons; Pharmacological Treatment; Phase; Population; Prevalence; Psychological Factors; Psychological Models; Public Health; Qualitative Methods; Quality of life; Radiation; Recurrence; Reporting; Research; Risk; Safety; Scientist; Severities; Study models; Symptoms; Time; Training; Trauma; United States; Work; alternative treatment; biopsychosocial; biopsychosocial factor; cancer care; cancer complication; cancer diagnosis; cancer pain; cancer survival; cancer therapy; career development; chemotherapy; chronic pain; coping; evidence base; experience; health care service utilization; improved; improved functioning; opioid epidemic; opioid therapy; pain catastrophizing; pain model; pain reduction; pain self-management; patient oriented; primary outcome; psychologic; secondary outcome; side effect; skills; social; social factors; social model; symptom science; treatment adherence; treatment strategy

Project Summary For many of the 26 million cancer survivors living in the United States today, lingering treatment-related symptoms pose a considerable problem. One such symptom is chronic pain, which is twice as prevalent in cancer survivors than in the general population, and has been shown to reduce quality of life (QoL), lower treatment adherence to cancer surveillance, and contribute to higher healthcare utilization. Although there is increased awareness of the magnitude and ramification of chronic cancer pain, what is not known are the unique cancer-specific factors that contribute to the chronic-cancer pain experience. Biological, social, and psychological (BPS) factors heavily influence chronic pain in non-cancer populations. However, cancer pain has typically been excluded from chronic pain studies, and as such, multimodal treatment strategies for cancer survivors are lacking. Due to a lack of alternative treatments, chronic cancer pain management relies on a biomedical model with opioid management being the cornerstone of treatment. As a consequence and despite little evidence to support this practice, cancer survivors are prescribed long-term opioid therapy at five times the rate of the general population but continue to report undertreated pain. Although psychological approaches such as cognitive-behavioral therapy and pain self-management have shown promising results in the general population, these have not been adapted to cancer survivors who likely have a unique chronic pain experience, due to cancer-specific factors, including the fear of recurrence and cancer-related distress. Without a clear understanding of the cancer-specific factors that drive the experience of chronic cancer pain and a deeper understanding of the lived experience of cancer survivors with chronic pain, the ability to develop effective multimodal treatments to reduce pain and improve function and quality of life is extremely limited. This fellowship award will allow the applicant to gain the knowledge and skills needed to work towards the achievement of her long-term goal; to produce actionable knowledge to improve pain management, quality of life and enhance opioid safety in individuals with cancer. The short-term goal of this study is to use a multimethod approach to 1) describe the lived experience of chronic pain in cancer survivors and 2) identify the unique biopsychosocial factors that are associated with the pain experience among cancer survivors with chronic pain. The central hypothesis is that unique cancer-specific factors will impact the chronic cancer pain experience, and therefore, can be targets of future interventions. This training award will allow the applicant to build on her clinical background in the management of cancer pain and expand her research skills in symptom science through the use of quantitative and qualitative methods. The applicant has assembled a mentoring team composed of interdisciplinary experts with strong methodologic backgrounds in cancer pain research, symptom science, and cancer distress. The applicant's career development goals are to become an independent nurse scientist and a leader in the field of cancer pain research.

项目概要 对于当今生活在美国的 2600 万癌症幸存者中的许多人来说，与治疗相关的挥之不去的问题 症状构成了一个相当大的问题。其中一种症状是慢性疼痛，其患病率是其他人的两倍 癌症幸存者的癌症生存率高于一般人群，并且已被证明会降低生活质量 (QoL)、降低 治疗依从于癌症监测，并有助于提高医疗保健利用率。虽然有 人们对慢性癌症疼痛的严重程度和后果的认识有所提高，但尚不清楚的是 导致慢性癌症疼痛经历的独特癌症特异性因素。生物、社会和 心理（BPS）因素严重影响非癌症人群的慢性疼痛。然而，癌痛 通常被排除在慢性疼痛研究之外，因此癌症的多模式治疗策略 缺乏幸存者。由于缺乏替代治疗，慢性癌症疼痛的治疗依赖于 以阿片类药物管理为治疗基石的生物医学模型。结果，尽管如此 几乎没有证据支持这种做法，癌症幸存者被开出五次长期阿片类药物治疗 普通人群的比率，但仍然报告疼痛治疗不足。虽然心理方法 诸如认知行为疗法和疼痛自我管理等在一般情况下已显示出有希望的结果 人群，这些尚未适应可能有独特的慢性疼痛经历的癌症幸存者， 由于癌症特定因素，包括对复发的恐惧和癌症相关的痛苦。没有明确的 了解导致慢性癌症疼痛经历的癌症特异性因素，并更深入地了解 了解患有慢性疼痛的癌症幸存者的生活经历，培养有效的治疗方法的能力 减轻疼痛、改善功能和生活质量的多模式治疗极其有限。这 研究金奖将使申请人能够获得实现这一目标所需的知识和技能 实现她的长期目标；产生可操作的知识，以改善疼痛管理、治疗质量 生命并提高癌症患者的阿片类药物安全性。本研究的短期目标是使用 多方法方法 1) 描述癌症幸存者慢性疼痛的生活经历，2) 确定 与癌症幸存者的疼痛经历相关的独特生物心理社会因素 慢性疼痛。中心假设是独特的癌症特异性因素会影响慢性癌症疼痛 因此，经验可以成为未来干预措施的目标。该培训奖将使申请人能够 以她在癌症疼痛管理方面的临床背景为基础，拓展她在症状方面的研究技能 通过使用定量和定性方法的科学。申请人已组建了指导 由跨学科专家组成的团队，在癌症疼痛研究方面具有强大的方法学背景， 症状科学和癌症困扰。申请人的职业发展目标是成为 独立护士科学家和癌症疼痛研究领域的领导者。

项目成果

When treatment algorithms fail: A response to the development of a nomogram to determine the frequency of elevated risk for non-medical opioid use in cancer patients.

当治疗算法失败时：对列线图开发的响应，以确定癌症患者非医疗阿片类药物使用风险升高的频率。

• 发表时间: 2021
• 影响因子: 2.2
• 作者: Jones, Katie Fitzgerald;Sager, Zachary;Leiter, Richard E;Sanders, Justin J
• 通讯作者: Sanders, Justin J

"It Is So Easy For Them to Dismiss": A Phenomenological Study of Cancer Survivors With Chronic Cancer-Related Pain.

“他们很容易忽视”：对患有慢性癌症相关疼痛的癌症幸存者的现象学研究。

• 发表时间: 2023-08
• 影响因子: 2.8
• 作者: Jones, Katie Fitzgerald;Fu, Mei R;Wood Magee, Lisa;Merlin, Jessica;Check, Devon K;McTernan, Melissa;Bernacki, Rachelle;Bulls, Hailey Waddell
• 通讯作者: Bulls, Hailey Waddell

Exploring Factors Associated With Long-Term Opioid Therapy in Cancer Survivors: An Integrative Review.

探索与癌症幸存者长期阿片类药物治疗相关的因素：综合评价。

• 发表时间: 2021
• 影响因子: 4.7
• 作者: Jones, Katie Fitzgerald;Fu, Mei R;Merlin, Jessica S;Paice, Judith A;Bernacki, Rachelle;Lee, Christopher;Wood, Lisa J
• 通讯作者: Wood, Lisa J

Barriers to Buprenorphine Prescribing for Opioid Use Disorder in Hospice and Palliative Care.

临终关怀和姑息治疗中使用丁丙诺啡治疗阿片类药物使用障碍的障碍。

• 发表时间: 2022-08
• 影响因子: 4.7
• 作者: Janet Ho, Jiunling;Jones, Katie Fitzgerald;Sager, Zachary;Neale, Kyle;Childers, Julie W;Loggers, Elizabeth;Merlin, Jessica S
• 通讯作者: Merlin, Jessica S

De-Stigmatizing the Language of Addiction #429.

消除成瘾语言的污名化

• 发表时间: 2022-01
• 影响因子: 2.8
• 作者: Ho, J Janet;Jones, Katie F;Sager, Zachary;Wakeman, Sarah;Merlin, Jessica S
• 通讯作者: Merlin, Jessica S