HEALTH PROMOTION AND QUALITY OF LIFE IN CHRONIC ILLNESS

患有慢性病和残疾的人士有促进健康的需要 即使他们正在经历一种具有长期后果的疾病 (USDHHS，1991)。事实上，健康促进干预措施的必要性可能 强调这群人的生活质量和 继续独立生活的能力通常严重依赖于 维持他们“微弱的健康”(DeJong&Batavia，1991)。数据 针对长期病患者和残疾人士的健康促进需要 是最少的，尽管健康促进活动被认为是一种形式 包括多发性硬化症在内的慢性疾病的症状管理 (毫秒)。健康促进需求的评估和干预措施的设计 培养健康促进行为必须解决时间限制、 能源和流动性迫使慢性病患者做出选择 考虑到他们对生活质量的感觉，他们认为拥有最大的回报。 对成人慢性阻塞性肺疾病健康促进的少数研究结果 疾病和残疾表明，这一人群有阳性的， 对健康的多维感知(Stuifbergen等人，1990，Williams， 1983年)，对健康促进活动感兴趣(Becker等人，1989； 斯图夫伯根，1991；温姆斯，1987)，健康知识和 健康促进行为的参与度与 健康的生理和心理测量(Nosek，1984)。 这项为期五年的护理学习的目的是提炼和确认 可指导健康相关行业发展的解释模式 提高某一类型个体生活质量的干预措施 对于慢性病，MS，具体目标将在两个方面实现 阶段。第一阶段的重点将是细化和验证，通过 定性方法，前面确定的模型概念 定量研究。此第一阶段的重点是扩展 理解生活质量、健康的关键模型概念- 促进行为，搜索可能的其他概念，并 确定后续工作中使用的测量仪器 从框架的角度来看，阶段是概念的有效表示 第二阶段患有多发性硬化症的人的参考资料，数据收集自 将使用多发性硬化症患者(N=500)的大样本进行统计 检验变量关系和与理论模型的总体匹配 在第一阶段进行了细化，在阶段中确定了前因和影响因素 II将为今后测试该系统的效用提供依据 提出具体护理干预措施的统计确认模式 对于患有多发性硬化症的个人而言。

Persons with chronic and disabling conditions have health promotion needs even though they are experiencing a disease with long-term consequences (USDHHS, 1991). In fact, the need for health promotion interventions may be accentuated for this group of individuals whose quality of life and ability to continue living independently are often heavily dependent on maintaining their "narrow margin of health" (DeJong & Batavia, 1991). Data specific to the health promotion needs of the chronically ill and disabled are minimal, despite recognition of health promotion activities as a form of symptom management for chronic diseases, including Multiple Sclerosis (MS). Assessment of health promotion needs and design of interventions to foster health promotion behaviors must address how limitations in time, energy, and mobility force chronically ill persons to make choices they perceive as having maximum payoff, given their sense of quality of life. Findings from the few studies of health promotion for adults with chronic illnesses and disabilities suggest that this population has positive, multidimensional perceptions of health (Stuifbergen et al, 1990, Williams, 1983), is interested in health promotion activities (Becker et al, 1989; Stuifbergen, 1991; Warms,1987), and that health knowledge and participation in health-promoting behaviors are positively related to physiological and psychological measures of health (Nosek, 1984). The purpose of this five year nursing study is to refine and confirm an explanatory model that can guide development of health-related interventions for promoting quality of life in individuals with one type of chronic illness, MS, The specific aims will be accomplished in two phases. The focus in Phase I will be to refine and validate, through qualitative methods, the model concepts identified in previous quantitative studies. The focus of this first phase is to extend understanding of the key model concepts of quality of life, health- promoting behaviors, search for possible additional concepts, and to determine that the measurement instruments to be used in the subsequent phases are valid representations of the concepts as viewed from the frame of reference of the person with MS. In Phase II, data collected from a large sample of individuals with MS (N=500) will be used to statistically test variable relationships and overall fit to the theoretical model refined in Phase I. Antecedents and modifying factors identified in Phase II will provide the basis for future tests of the utility of the statistically confirmed model in proposing specific nursing interventions for individuals with MS.