Anxiety With Cancer in the Elderly (ACE): A Cognitive-Behavioral Interv

老年人癌症焦虑 (ACE)：认知行为干预

• 批准号: 9060809
• 负责人: Kelly McConnell
• 金额: $ 15.66万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-30 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9060809
• 关键词: Address; Adherence; Adult Children; Advance Care Planning; Advanced Malignant Neoplasm; Adverse effects; Affect; Age; Aging; Anxiety; Anxiety Disorders; Behavioral; Benchmarking; Cancer Center; Cancer Intervention; Cancer Patient; Caregivers; Caring; Clinical; Cognitive; Cognitive Therapy; Communication; Control Groups; Decision Making; Diagnostic; Distress; Dyspnea; Effectiveness; Elderly; Emotional; Enrollment; Environment; Fatigue; Feedback; Future; Geriatrics; Goals; Health; Health Personnel; Health Services Accessibility; Internet; Intervention; K-Series Research Career Programs; Life; Malignant Neoplasms; Manuals; Medical Care Team; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentorship; Minority Groups; Modeling; Modification; Nausea; New York; Nurse Practitioners; Oncologist; Pain; Palliative Care; Participant; Pathological anxiety; Patients; Performance Status; Phase; Physical Performance; Polypharmacy; Population; Presbyterian Church; Provider; Psychiatric Diagnosis; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Research Personnel; Resources; Risk; Role; Sampling; Self Efficacy; Social Workers; Spouses; Subgroup; Telephone; Terminal Disease; Time; Treatment Efficacy; Work; anxiety symptoms; anxiety treatment; base; cancer care; caregiver bereavement; caregiver interventions; caregiving; clinical care; clinically significant; cognitive function; compliance behavior; coping; cost; cost effective; design; dosage; effective therapy; end of life; experience; flexibility; improved; informal caregiver; medical schools; meetings; novel; oncology; physical conditioning; post intervention; primary caregiver; psychologic; psychosocial; racial and ethnic; secondary outcome; social; therapy design; treatment adherence; treatment as usual; treatment response; young adult; Address; Adherence; Adult Children; Advance Care Planning; Advanced Malignant Neoplasm; Adverse effects; Affect; Age; Aging; Anxiety; Anxiety Disorders; Behavioral; Benchmarking; Cancer Center; Cancer Intervention; Cancer Patient; Caregivers; Caring; Clinical; Cognitive; Cognitive Therapy; Communication; Control Groups; Decision Making; Diagnostic; Distress; Dyspnea; Effectiveness; Elderly; Emotional; Enrollment; Environment; Fatigue; Feedback; Future; Geriatrics; Goals; Health; Health Personnel; Health Services Accessibility; Internet; Intervention; K-Series Research Career Programs; Life; Malignant Neoplasms; Manuals; Medical Care Team; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentorship; Minority Groups; Modeling; Modification; Nausea; New York; Nurse Practitioners; Oncologist; Pain; Palliative Care; Participant; Pathological anxiety; Patients; Performance Status; Phase; Physical Performance; Polypharmacy; Population; Presbyterian Church; Provider; Psychiatric Diagnosis; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Research Personnel; Resources; Risk; Role; Sampling; Self Efficacy; Social Workers; Spouses; Subgroup; Telephone; Terminal Disease; Time; Treatment Efficacy; Work; anxiety symptoms; anxiety treatment; base; cancer care; caregiver bereavement; caregiver interventions; caregiving; clinical care; clinically significant; cognitive function; compliance behavior; coping; cost; cost effective; design; dosage; effective therapy; end of life; experience; flexibility; improved; informal caregiver; medical schools; meetings; novel; oncology; physical conditioning; post intervention; primary caregiver; psychologic; psychosocial; racial and ethnic; secondary outcome; social; therapy design; treatment adherence; treatment as usual; treatment response; young adult

DESCRIPTION (provided by applicant): This application proposes to develop and evaluate Anxiety with Cancer in the Elderly (ACE), a cognitive-behavioral therapy-based (CBT) intervention for anxiety designed to meet the unique needs of older adults (OAs; ≥65 years) with advanced cancer and their informal caregivers (spouse/partner, adult children). This study will develop ACE (Phase I); obtain feedback on ACE from cancer patients, their caregivers, and healthcare providers (Phase II); and examine the acceptability, feasibility, and efficacy of ACE (Phase III). Significance. Anxiety is prevalent in OA cancer patients and their informal caregivers and is associated with more severe physical side-effects, poor quality of life and treatment adherence, poor communication with the healthcare team, and a weaker patient-oncologist alliance. In addition, over half of advanced cancer patients who meet diagnostic criteria for a psychiatric disorder do not receive treatment. CBT is a well-validated treatment for anxiety. However, traditional CBT has not been tailored to meet the unique needs of OAs with advanced cancer and their caregivers. Specific Aims. This study will develop and evaluate the feasibility and acceptability of a CBT-based intervention for anxiety in OAs with advanced cancer and their informal caregivers. This study will also examine the impact of the intervention on anxiety, depression, quality of life, coping, and patient-oncologist communication and alliance. Long-Term Objectives. This study will support a more extensive examination of this intervention with larger more diverse samples, leading to a widely validated and disseminable intervention tailored to OAs with advanced cancer and their caregivers. Research Plan. For Phase I, ACE, a CBT intervention for OAs with advanced cancer will be developed. In Phase II, ten patients, age 65 years or older and their primary caregiver and ten healthcare providers with experience in geriatric care will be asked to review ACE and provide feedback. In Phase III, forty OA cancer patients with advanced cancer and clinically significant anxiety and their caregivers will be randomly assigned to ACE or usual care control condition. Patients will complete assessments at baseline, during the intervention, and post intervention. Environment. Participants will be recruited from the New York Presbyterian Cancer Center, one of the largest cancer care centers in NYC with ample patient availability. The PI will receive mentorship from internationally recognized clinical researchers and leaders in aging, psychooncology, and palliative care and will leverage the rich and diverse resources from the Weill Cornell Medical College (WCMC) Center for End-of- Life Research and the Division of Geriatrics and Palliative Care. Relevance to Aging. This study will provide a non-pharmacologic treatment that will reduce anxiety and improve quality of life in OAs with advanced cancer and their caregivers and will support future research on interventions for OAs of minority groups and with other life-limiting illnesses.

描述（由应用提供）：该申请提案旨在为老年人（ACE）发展和评估焦虑症，这是一种基于认知的行为疗法（CBT）的焦虑干预措施，旨在满足老年人（OAS;≥65岁）与晚期癌症的独特需求（OAS；≥65岁）的焦虑症（配偶/伴侣/成年儿童）。这项研究将发展ACE（I阶段）；从癌症患者，他们的护理人员和医疗保健提供者那里获得有关ACE的反馈（第二阶段）；并检查ACE的可接受性，可行性和效率（第三阶段）。意义。 OA癌症患者及其非正式护理人员普遍存在焦虑 并且与更严重的身体副作用，较差的生活质量和治疗依从性，与医疗保健团队的沟通不佳以及患者对障碍的联盟相关。此外，符合精神疾病诊断标准的高晚期癌症患者中，超过一半的患者无法接受治疗。 CBT是焦虑的验证疗法。但是，传统的CBT尚未量身定制以满足OAS晚期癌症及其护理人员的独特需求。具体目标。这项研究将开发和评估基于晚期癌症及其非正式护理人员的OA中基于CBT的干预措施的可行性和可接受性。这项研究还将研究干预对动画，抑郁，生活质量，应对和患者对患者的沟通和联盟的影响。长期目标。这项研究将支持对这种干预措施进行更广泛的研究，并提供更大的样本，从而导致针对患有晚期癌症及其护理人员的OA量身定制的广泛验证且可忽视的干预措施。研究计划。对于第一阶段的ACE，将开发针对患有晚期癌症的OA的CBT干预。在第二阶段，将要求10名年龄65岁以上的患者及其初级护理人员和十名具有老年护理经验的医疗保健提供者来审查ACE并提供反馈。在第三阶段，患有晚期癌症和临床意义的焦虑症患者及其护理人员将随机分配到ACE或通常的护理控制状态。患者将在基线，干预期间和干预后完成评估。环境。参与者将从纽约长老会癌症中心招募，纽约长老会癌症中心是纽约最大的癌症护理中心之一，患者可用。 PI将受到国际认可的临床研究人员和衰老，心理学和姑息治疗领导者的心态，并将利用Weill Cornell医学院（WCMC）中心的富裕和潜水资源，用于生命终结研究，以及老年人和姑息治疗部。与衰老有关。这项研究将提供一种非药物治疗，可减少患有晚期癌症及其护理人员的OA的焦虑并改善生活质量，并将支持对少数群体和其他限制生命疾病的OAS干预措施的未来研究。