HEALTH-RELATED QUALITY OF LIFE IN ARTHRITIS AND AIDS

描述(改编自申请人的摘要)：适用于慢性阻塞性肺病患者 艾滋病和类风湿性关节炎等疾病，与健康相关的生活质量 (HRQOL)已成为卫生保健的一个重要成果。争论仍在继续， 然而，关于HRQOL的维度和贡献者与他们的 相关性和相对重要性，它们的影响力的强度，以及它们的 动态化的本质。虽然争论仍在继续，但有三个一般性的 同意的领域：(1)HRQOL是一个多层面的概念；(2) HRQOL的评估是主观的；(3)HRQOL的研究应以 强大的概念性模型。这份修改后的申请提出了一种辅助数据 分析以检验Wilson and Cleary(1995)HRQOL模型，该模型确定了6个 HRQOL的各个维度，然后纵向评估这些关系 变化。这六个维度包括生物和生理变量， 症状状态、功能状态、总体健康状况、特征 以及环境的特点。 使用结构方程模型，美国风湿病的数据 协会医疗信息系统(ARAMIS)与艾滋病的时效性 将使用两个已建立的数据库--健康结果研究(Athos)。两个都是 这些数据库有一个或多个测量变量可用作 模型中每个维度的指示器。了解 HRQOL各维度之间的关系和联系，以及这些 随着时间的推移，关系的变化将有助于设计和确定目标 为高质量的患者护理提供适当的干预，提供丰富的信息 揭示趋势，建议提供商变化与患者之间的关系 结果，并确定潜在的有问题的护理模式。传统型 HRQOL测量没有提供足够的信息来理解 病人护理的结果。随着护士的关注预防，健康促进， 症状管理，以及缓解急慢性疾病的影响，a 有效的HRQOL模型可能是捕捉其对以下方面影响的适当策略 病人护理。一个有效的概念性模型，它涵盖了整个 健康-疾病连续体不仅对护理有价值，而且对 消费者、提供商、管理员和政策制定者。

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.