HEALTH-RELATED QUALITY OF LIFE IN ARTHRITIS AND AIDS

描述（改编自申请人摘要）：对于慢性 艾滋病和类风湿性关节炎等疾病，与健康有关的生活质量 （HRQOL）已成为医疗保健的重要成果。争论仍在继续， 然而，关于HRQOL的维度和贡献者， 相关性和相对重要性，其影响力的强度， 动态自然虽然仍有争议，但有三个一般性问题， 一致的领域：（1）HRQOL是一个多维度的概念;（2） HRQOL的评价是主观的;（3）HRQOL的研究应基于 强大的概念模型。本修订申请提出了一个辅助数据 Wilson和Cleary（1995）HRQOL模型的分析，该模型确定了六个 HRQOL的维度，然后评估，纵向，如何关系 变化这六个维度包括生物和生理变量， 症状状态，功能状态，一般健康感知，特征 和环境的特征。 使用结构方程模型，数据来自美国莱茵河 协会医疗信息系统（ARAMIS）和艾滋病时间导向 健康结果研究（ATHOS），两个已建立的数据库，将被使用。两 这些数据库具有一个或多个测量变量， 模型中每个维度的指标。了解 HRQOL各维度之间的关系和联系，以及这些维度如何 随着时间的推移，关系的变化将有助于设计和定位 适当的干预措施，为优质的病人护理，提供丰富的信息， 揭示趋势，提示提供者变化与患者之间的关系 结果，并确定潜在的问题模式的照顾。传统 HRQOL测量没有提供足够的信息来了解 病人护理的结果。随着护士们对预防，健康促进， 症状管理，缓解急性和慢性疾病的影响， 一个有效的HRQOL模型可能是捕捉其影响的适当策略 病人护理一个有效的概念模型，捕捉HRQOL在整个 健康-疾病连续体不仅对护理有价值， 消费者、提供者、管理者和政策制定者。

DESCRIPTION (adapted from the applicant's abstract): For patients with chronic illnesses such as AIDS and rheumatoid arthritis, health-related quality of life (HRQOL) has emerged as an important outcome of health care. Debate continues, however, about the dimensions of and contributors to HRQOL in relation to their relevance and relative importance, the strengths of their influence, and their dynamic nature. While there continues to be debate, there are three general areas of agreement: (1) HRQOL is a multi-dimensional concept; (2) the assessment of HRQOL is subjective; and (3) research on HRQOL should be based on strong conceptual models. This amended application proposes a secondary data analysis to test the Wilson and Cleary (1995) HRQOL model that identifies six dimensions of HRQOL and then to evaluate, longitudinally, how the relationships change. The six dimensions include biological and physiological variables, symptoms status, functional status, general health perception, characteristics of the individual, and characteristics of the environment. Using structural equation modeling, data from The American Rheumatism Association Medical Information System (ARAMIS) and The AIDS Time-Oriented Health Outcome Study (ATHOS), two established databases, will be used. Both of these databases have one or more measured variables that can be used as indicators for each of the dimensions in the model. Understanding the relationships and linkages among the dimensions of HRQOL and how these relationships change over time will facilitate the design and targeting of appropriate interventions for quality patient care, provide rich information to reveal trends, suggest relationships between provider variations and patient outcomes, and identify potentially problematic patterns of care. Traditional HRQOL measures have not provided sufficient information for understanding the outcomes of patient care. With nurses' focus on prevention, health promotion, symptom management, and the alleviation of acute and chronic illness effects, a valid HRQOL model may be the appropriate strategy for capturing their impact on patient care. A valid conceptual model that captures HRQOL throughout the health-illness continuum would be valuable not only to nursing, but to consumers, providers, administrators, and policy makers.