Promoting Resilience In Stress Management Research Articles

Impact of palliative care interventions on health-related quality of life (HRQOL): A secondary analysis of the Promoting Resilience in Stress Management (PRISM) Randomized Controlled Trial (RCT).

78 Background: PRISM, a novel intervention for adolescents and young adults (AYAs), seeks to enhance resilience skills via four in-person sessions. Primary analysis of the RCT in AYAs with cancer showed PRISM improved HRQOL. This secondary analysis aimed to explore changes in HRQOL domains and differences between patient groups. Methods: English-speaking AYAs (12 - 25 years) were randomized to PRISM or usual care (UC) from Jan 2015 - Oct 2016. Surveys were completed at enrollment and six months later, using the Pediatric Quality of Life Inventory (PedsQL) Generic Short Form (SF-15) and Cancer Module to assess HRQOL. We compared change scores (PRISM vs UC) by domain (PedsQL SF-15: physical, emotional, social, school; cancer: pain, nausea, procedure anxiety, treatment anxiety, worry, cognition, perceived appearance, and communication). Participants were stratified by age (12 - 17 years vs 18 - 25 years) and advanced cancer status (yes/no). Results: 74 patients (36 PRISM, 38 UC) completed 6-month assessments. 72% were 12 - 17 years old. 23% had advanced cancer at enrollment. PRISM improved patient-reported communication (UC: median [interquartile range, IQR] 0 [-17, 8]; PRISM: 8 [0, 25]). Younger patients seemed to benefit more, especially in PedsQL SF-15 school (12 - 17: UC 0 [-8, 0], PRISM 13 [0, 17]; 18 - 25: UC 0 [-33, 17], PRISM 0 [-25, 17]) and social domains (12 - 17: UC 0 [-33, 0], PRISM 0 [0, 8]; 18 - 25: UC 0 [-25, 4], PRISM -17 [-25, 8]), and cancer-specific perceived appearance (12 - 17: UC -4 [-25, 0], PRISM 8 [-8, 25]; 18-25: UC 0 [-21, 0], PRISM -8 [-25, 17]). Patients with advanced cancer seemed to benefit in cancer-specific domains nausea (no: UC 0 [-10, 15], PRISM 10 [-10, 40]; yes: UC 6 [-15, 25], PRISM 35 [25, 50]) and pain (no: UC 13 [-13, 25], PRISM 6 [-13, 25]; yes: UC -13 [-25, 0], PRISM 6 [-13, 25]). Patients without advanced cancer seemed to benefit in perceived appearance (no: UC -6 [-33, 0], PRISM 0 [-8, 17]; yes: UC 0 [-8, 17], PRISM 4 [-8, 17]). Conclusions: With PRISM, younger AYAs were better able to cope with age appropriate challenges (social, school, appearance) and AYAs with advanced cancer improved physical symptom HRQOL. Clinical trial information: NCT02340884.

Promoting Resilience in Stress Management: A Pilot Study of a Novel Resilience-Promoting Intervention for Adolescents and Young Adults With Serious Illness.

To examine the feasibility and format of the Promoting Resilience in Stress Management (PRISM) intervention among two groups of adolescents and young adults (AYAs) at-risk for poor outcomes: those with Type 1 diabetes (T1D) or cancer. PRISM consists of two long or four short skills-based modules. English-speaking patients 12-25 years old were eligible if they had T1D for >6 months or cancer for >2 weeks. Feasibility was defined as an 80% completion rate and high satisfaction. Ongoing monitoring shaped iterative refinement of disease-specific approach. 12 of 15 patients with T1D (80%) completed the two-session intervention. 3 of 15 patients with cancer declined to complete the two-session version, citing prohibitive length of individual sessions. 12 (80%) completed the four-session version. Patient-reported satisfaction was high across groups. The PRISM intervention is feasible and well-accepted by AYAs with cancer or T1D. Differences in patient populations warrant differences in approach.