HEALTH PROMOTION AND QUALITY OF LIFE CHRONIC ILLNESS

慢性致残性疾病对老年人有着深远而广泛的影响， 数百万美国人的生命。尽管很少涉及， 健康促进工作继续存在，并可能在人 长期处于无法治愈的状态这五年的目的 竞争性的延续是增加健康促进知识的深度 在慢性残疾条件下，通过纳入纵向随访 现有的农村和城市多发性硬化症患者样本 (MS)，整合额外的结果措施。还将扩大 健康促进知识和残疾人生活质量 慢性神经退行性疾病通过验证的解释 模型在本研究中细化的人群与 不同的慢性病，脊髓灰质炎后综合症。具体目标是 (1)对当前项目中的人员进行纵向跟踪， 检查时间的影响和疾病相关的轨迹 残疾对一系列生活质量结果的影响（感知生活质量） 生活，就业，抑郁症和继发性残疾）;（2）检查 健康促进行为、障碍和资源的影响 个人在多个时间点改变轨迹， 控制与疾病有关的残疾的影响;（3） 完善健康促进和质量的解释模型 在目前的研究中， 人口，患有小儿麻痹症后综合症的人。 对现有MS患者样本（N=759）进行了5年随访， 仅5%的样本在2年时失访， 90%的人回答了时间2问卷。第二个样本的人， 将招募脊髓灰质炎后患者（N=500）。仪器和数据收集 本研究中完善的程序将纳入 延续。纵向数据将采用分层线性分析 模型（HLM）和事件历史分析。结构方程模型 (SEM)技术将用于验证和完善模型， 小儿麻痹症后群体本研究的信息将用于设计 慢性神经退行性变患者的护理干预 条件

Chronic disabling conditions have profound and pervasive effects on the lives of millions of Americans. Although rarely addressed, the need for health promotion continues to exist and may be accentuated in persons living with long-term, incurable conditions. The purpose of this five year competing continuation is to add depth to knowledge about health promotion in chronic disabling conditions by incorporation a longitudinal follow-up of the existing sample of rural and urban persons with multiple sclerosis (MS), integrating additional outcome measures. It will also expand knowledge of health promotion and quality of life among persons with chronic neurodegenerative conditions through validation of the explanatory model refined in the present study in a population of persons with a different chronic condition, post-polio syndrome. The specific aims are to (1) Conduct a longitudinal follow-up of persons in the current project to examine the effects of time and the trajectory of illness-related disability on a range of quality of life outcomes (perceived quality of life, employment, depression, and secondary disabilities); (2) Examine the influence of health promoting behaviors, barriers, and resources on individual change trajectories over multiple points in time, when controlling for the effects of illness-related disability; and (3) Validate and refine the explanatory model of health promotion and quality of life developed in the current study with an additional chronic disease population, persons with post-polio syndrome. A five year follow-up of the existing sample of persons with MS (N=759) is proposed; only 5% of the sample has been lost to follow-up at 2 years and 90% responded to a Time 2 questionnaire. A second sample of persons with post-polio (N=500) will be recruited. Instruments and data collection procedures refined in the present study will be incorporated in the continuation. Longitudinal data will be analyzed with hierarchical linear models (HLM) and event history analysis. Structural equation modeling (SEM) techniques will be used to validate and refine the model in the post-polio group. Information from this study will be used to design nursing interventions for persons with chronic neurodegenerative conditions.