An Intervention to Reduce Psychosocial and Biological Indicators of Stress in African American Lupus Patients: The Balancing Lupus Experiences with Stress Strategies Study.
An Intervention to Reduce Psychosocial and Biological Indicators of Stress in African American Lupus Patients: The Balancing Lupus Experiences with Stress Strategies Study.
复制标题
DOI：
10.4236/ojpm.2014.41005
复制
发表时间：
2014-01-01
期刊：
影响因子：
--
通讯作者：
Oates, James C
中科院分区：
文献类型：
--
作者：
Williams, Edith M;Penfield, Megan;Oates, James C
目的：关于心理社会压力对非裔美国狼疮患者的影响知之甚少。由于非裔美国人一生中暴露于独特的压力源轨迹，因此了解心理社会压力与影响该高危人群疾病活动和病理的潜在生物学机制之间的关系可能至关重要。平衡狼疮经验与压力策略（BLESS）研究试点验证“更好的选择，在南卡罗来纳州医科大学（MUSC）参加SLE临床数据库项目的30名非洲裔美国狼疮患者中实施“更好的健康”慢性病自我管理计划（CDSMP）。在干预活动之前和之后以及干预后四个月，在每种研究条件下收集所有患者的心理社会和生物压力指标的测量值，以评估该计划在减少感知和生物压力指标方面的有效性。结果：参加研讨会对抑郁症有很大的影响（d=1.63和d = 1.68），社会/角色活动限制（d =1.15）、健康困扰（d =1.13和d = 0.78）、疲劳（d =1.03）、疼痛（d =0.96）和狼疮自我效能（d =0.85）。无论是皮质醇或脱氢表雄酮水平干预前和干预后的差异被认为是干预参与者和controls.CONCLUSION之间的显着差异：干预研讨会采取行动，以减少感知压力，提高生活质量。我们的研究结果意味着，如果不是更显着的收益，在相关的健康指标是可能的非洲裔美国患者提供的机会，参加CDSMP的。
OBJECTIVE: Very little is known about the impact of psychosocial stress on African American lupus patients. Due to the exposure of African Americans to a unique trajectory of stressors throughout life, it may be critical to understand the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in this high risk group.METHODS: The Balancing Lupus Experiences with Stress Strategies (BLESS) study piloted the validated "Better Choices, Better Health" Chronic Disease Self-Management Program (CDSMP) in 30 African-American lupus patients participating in the SLE Clinic Database Project at the Medical University of South Carolina (MUSC). Measures of psychosocial and biological indicators of stress were collected in all of the patients in each of the study conditions before and after intervention activities, as well as four months post-intervention, to assess the effectiveness of the program in reducing perceived and biological indicators of stress.RESULTS: Participation in the workshops had large effects upon depression (d=1.63 and d = 1.68), social/role activities limitations (d =1.15), health distress (d =1.13 and d = 0.78), fatigue (d =1.03), pain (d =0.96), and lupus self-efficacy (d =0.85). Neither the differences in cortisol or DHEA levels pre- and post-intervention were found to be significantly different between intervention participants and controls.CONCLUSION: The intervention workshops acted to reduce perceived stress and improve quality of life. Our findings imply that comparable, if not more significant gains in relevant health indicators are possible in African American patients when provided the opportunity to participate in CDSMP's.