Training clinical providers in evidence-based hypnosis for cancer pain management

对临床提供者进行癌症疼痛管理循证催眠培训

基本信息

批准号：
10597587
负责人：
Guy H Montgomery
金额：
$ 32.34万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-13 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10597587
关键词：
Activities of Daily Living Acute Acute pain management Adoption Adult Ally American American Society of Clinical Oncology Attitude Behavior Biological Bone Pain Cancer Pain Management Cancer Patient Cancer Survivor Chronic Chronic Cancer Pain Clinical Clinical Competence Cognitive Country Cultural Sensitivity Degree program Diagnosis E-learning Education Educational workshop Effectiveness Eligibility Determination Empathy Enrollment Ensure Evaluation Exercise Feedback Film Future Goals Guidelines Healthcare promotion Healthy People 2020 Hormonal Hospitalization Hypnosis Intervention Knowledge Learning Licensing Link Malignant Neoplasms Medical Meta-Analysis Methods Mind-Body Intervention Minority Mission Modality Multimedia Musculoskeletal Pain National Comprehensive Cancer Network Neuropathy Operative Surgical Procedures Pain Pain management Participant Patient Self-Report Patients Phase Play Postoperative Pain Preparation Professional Organizations Program Evaluation Provider Publishing Quality of Care Quality of life Questionnaires Radiation therapy Radiodermatitis Recommendation Recording of previous events Reporting Research Role Self Efficacy Site Source Standardization Surveys Survivors Techniques Terminal Disease Therapeutic Thinking Time Training Training Programs anticancer treatment cancer care cancer pain cancer therapy care providers chemotherapy chronic pain chronic pain management clinical efficacy clinical practice clinical training cohort coping cost effective curative treatments effectiveness evaluation efficacious intervention evidence base experience health care quality hypnotic improved lectures mind/body online resource pain reduction pharmacologic programs psychologic psychosocial recruit research clinical testing response satisfaction skills survivorship symposium symptom management theories transfer learning

项目摘要

Rationale: In 2019, over 1.7 million Americans will be diagnosed with cancer. Among the innumerable rigors associated with the diagnosis, perhaps the greatest source of suffering is pain. Pain can be associated with the cancer itself, as well as with cancer treatments including. It is estimated that 39% of patients experience pain following curative treatment, 55% during anticancer treatment, 40%of survivors experience pain,and 66% of patients in advanced, metastatic, or terminal disease phases report pain. Unfortunately, approximately third are one- of patients with cancer-related pain are undertreated for that pain, and that the odds of undertreatment twice as high for minorities Major cancer organizations have published pain management guidelines which. recognize (e.g., hypnosis. The inclusion of hypnosis in these guidelines is based on a evidence supporting the clinical efficacy of hypnosis for acute and chronic pain management. Meta-analysis has the importance of integrating mind-body approaches ASCO, NCCN), among long history of empirical which is indicated that on average 77%-95% of patients benefit from hypnotic pain management relative to control participants. However, hypnosis training is not a standard component of either standard cancer provider education or pain management training. As a result, this clinically efficacious intervention is rarely used by providers to help patients in need. Objective: The goal of the proposed R25E is to train cancer care providers in hypnosis to manage cancer pain. The Specific Aims are to: 1) Refine and implement a Hypnosis for Cancer Pain (HCaP) training program; 2) Evaluate the effectiveness of the HCaP training on providers' knowledge, skills, attitudes, and self-efficacy for using hypnosis to manage cancer pain; and, 3) Evaluate the impact of the HCaP training program on trainees' real-world practice, using a mixed-methods approach. The HCaP training content is guided by sociocognitive theory. Training will focus on the following domains: 1) Understanding Cancer Pain; 2) Understanding Hypnosis; 3) Using Hypnosis for Cancer Pain Management; 4) Using Hypnosis for Managing Symptoms, Thoughts, and Behaviors Associated with Pain; and, 5) Hypnosis Metacompetencies (e.g., therapeutic alliance, empathy, cultural sensitivity). The evaluation plan for HCaP is guided by Miller's pyramid of clinical competencies, and will focus on three levels of evaluation: Knowledge and Practical Understanding, Skills, and Clinical Practice. Methods: Cancer care providers (N=400; including medical, allied, and psychosocial providers) from across the country will be recruited via professional organizations, listservs, and conferences. Trainees will participate in a blended training program including multimedia E-Learning and a 2-day live workshop, with evaluations linked to each modality. Trainees will also be evaluated at 3 months following the workshop. Long-term goals: The proposed R25E is a critical first step toward improving quality of care and quality of life for cancer patients in pain. Connection to NCI mission: This project is consistent with the Healthy People 2020 goal of improving quality of life of cancer patients and survivors.

理由：2019 年，超过 170 万美国人将被诊断出患有癌症。在无数的严酷考验中与诊断相关，也许最大的痛苦来源是疼痛。疼痛可能与癌症本身，以及癌症治疗。据估计 39% 的患者会经历疼痛在治愈性治疗后，55% 的幸存者在抗癌治疗期间，40% 的幸存者经历疼痛，66% 处于晚期、转移性或末期疾病阶段的患者报告有疼痛。不幸的是，大约第三是一- 患有癌症相关疼痛的患者没有得到充分治疗，并且治疗不足的几率少数族裔的发病率是其两倍主要癌症组织已发布疼痛管理指南。认识（例如，催眠。将催眠纳入这些指南是基于以下证据：支持催眠治疗急性和慢性疼痛的临床疗效。荟萃分析有整合身心方法的重要性（ASCO、NCCN），其中经验主义的悠久历史这是表明相对于控制，平均 77%-95% 的患者从催眠疼痛管理中受益参与者。然而，催眠训练并不是标准癌症提供者的标准组成部分教育或疼痛管理培训。因此，这种临床上有效的干预措施很少被使用提供者帮助有需要的患者。目标：拟议 R25E 的目标是培训癌症护理提供者通过催眠来控制癌症疼痛。具体目标是： 1) 完善和实施癌症催眠术疼痛（HCaP）培训计划； 2) 评估 HCaP 培训对提供者知识的有效性，使用催眠治疗癌症疼痛的技能、态度和自我效能； 3) 评估影响 HCaP 培训计划针对学员的实际实践，采用混合方法。 HCaP 培训内容以社会认知理论为指导。培训将重点关注以下领域： 1) 理解癌症疼痛； 2）了解催眠； 3）使用催眠治疗癌症疼痛； 4）使用催眠用于管理与疼痛相关的症状、想法和行为；以及，5) 催眠元能力（例如，治疗联盟、同理心、文化敏感性）。 HCaP 的评估计划以 Miller 的指导临床能力金字塔，将侧重于三个层次的评估：知识和实践理解、技能和临床实践。方法：癌症护理提供者（N=400；包括医疗、联合、来自全国各地的社会心理服务提供者）将通过专业组织、列表服务器、和会议。学员将参加混合培训计划，包括多媒体电子学习和为期 2 天的现场研讨会，评估与每种模式相关。学员还将在三个月后接受评估研讨会结束后。长期目标：拟议的 R25E 是提高质量的关键第一步疼痛中的癌症患者的护理和生活质量。与 NCI 任务的联系：该项目与 Healthy People 2020 的目标是提高癌症患者和幸存者的生活质量。