ADHERENCE AND ADJUSTMENT IN END-STAGE RENAL DISEASE

终末期肾病的坚持和调整

• 批准号: 6489684
• 负责人: ALAN J CHRISTENSEN
• 金额: $ 12.83万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-01-01 至 2003-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6489684
• 关键词: behavioral /social science research tag; chronic renal failure; clinical research; continuous ambulatory peritoneal dialysis; coping; emotional adjustment; health behavior; hemodialysis; human subject; human therapy evaluation; kidney transplantation; longitudinal human study; quality of life; self care; therapy compliance

DESCRIPTION (adapted from investigator's abstract): Increased quality assurance concerns associated with the Medicare End-Stage Renal Disease (ESRD) program underscore the need for research addressing the adaptation and quality of life of ESRD patients. Patients' levels of psychological adjustment and their degree of adherence with ESRD treatment regimen reflect two important criteria that are examined in the present continuation proposal. One central objective of the research involves identifying psychological characteristics that influence medical regimen adherence and emotional adjustment among patients treated with renal dialysis. This will be accomplished using a longitudinal study design that considers the effects of patient individual differences (i.e., coping style) and contextual differences among the available dialysis treatment modalities. A key aspect of the study involves the assessment of patients at an early stage of progressive renal insufficiency, before renal dialysis is clinically necessary. We hypothesize that adherence and adjustment will vary as a joint function of the type of dialysis prescribed and patient individual differences assessed at baseline. For example, we predict that patients' possessing a more active or vigilant style of coping will exhibit more favorable adherence when undergoing a self-administered dialysis treatment modality (e.g., continuous ambulatory peritoneal dialysis) but poorer adherence when receiving staff administered dialysis (e.g., center hemodialysis). A second objective involves identifying patient characteristics that are related to adherence to adjustment among renal transplantation patients. Initial psychosocial assessment will be conducted during the pre-transplant evaluation process. A set of hypotheses regarding psychological predictors of patient adherence and changes in emotional well being after transplantation will be tested in a prospective manner. For Example, we hypothesize that patients with a more active style of coping with health-related stress will exhibit better regimen adherence and better emotional adjustment than other transplant patients. We believe the proposed research will extend the role of psychological theory and practice in contributing to the care of ESRD patients. The knowledge generated will add to a growing body of literature that suggests psychosocial assessment information can be useful in the selection f the most beneficial renal treatment modality for a particular patient.

描述（根据调查员的摘要改编）：提高质量保证 与Medicare终末期肾脏疾病（ESRD）计划相关的担忧 强调了解决适应和生活质量的研究的需求 ESRD患者。患者的心理适应水平及其学位 遵守ESRD治疗方案，反映了两个重要标准 在目前的延续建议中进行了检查。 研究的一个核心目标是确定心理 影响医学方案依从性和情感的特征 用肾透析治疗的患者进行调整。这将是 使用纵向研究设计完成了，该设计考虑了 患者个体差异（即应对样式）和上下文差异 在可用的透析治疗方式中。研究的关键方面 涉及在进行性肾脏早期对患者的评估 在临床上有必要的肾脏透析之前，不足。我们假设 这种依从性和调整将随着类型的联合功能而变化 在基线时评估了透析和患者的个人差异。 例如，我们预测患者具有更活跃或更加警惕 进行应对方式将表现出更有利的依从性 自我管理的透析治疗方式（例如，连续卧床 腹膜透析）但接收员工时的依从性较差 透析（例如中心血液透析）。 第二个目标涉及确定患者特征 与肾移植患者之间的遵守有关。 最初的社会心理评估将在移植前进行 评估过程。关于关于心理预测指标的一组假设 移植后的患者依从性和情绪健康的变化 将以预期的方式进行测试。例如，我们假设 与健康相关压力的应对方式更活跃的患者将 比其他 移植患者。我们认为拟议的研究将扩展 心理理论和实践有助于ESRD患者的护理。 所产生的知识将增加越来越多的文献，这表明 心理社会评估信息在选择最有用 特定患者的有益肾脏治疗方式。