Disclosure and Skills Training for Rheumatoid Arthritis

类风湿关节炎的披露和技能培训

• 批准号: 6821582
• 负责人: MARK A LUMLEY
• 金额: $ 55.21万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6821582
• 关键词: acute phase protein; analgesia; arthritis education; arthritis therapy; behavior therapy; chronic pain; clinical research; clinical trials; coping; human middle age (35-64); human subject; human therapy evaluation; patient oriented research; personal log /diary; rheumatoid arthritis

DESCRIPTION (provided by applicant): Two self-management interventions have promise for improving the health and adjustment of people with rheumatoid arthritis (RA): written emotional disclosure (ED) and coping skills training (CST). These approaches have evolved separately and not been compared, and an intervention that integrates ED with CST may be more effective than either one alone. The proposed study combines the expertise of two research teams to conduct a randomized, controlled trial of the integrated and separate effects of ED and CST for people with RA. Adults with RA (N = 280) will be randomized to one of four treatment groups in a 2 X 2 factorial design. One factor is six sessions of either ED (writing about stress, RA, and coping options) or its matched control, neutral writing. The second factor is 6 sessions of therapist-provided CST (teaching six pain and stress coping skills) or its matched control, nurse-provided arthritis education. Thus, the 4 treatments are: a) integrated ED / CST; b) ED (+ arthritis education); c) CST (+ neutral writing); and d) Control (neutral writing + arthritis education). A comprehensive battery of measures (pain, physical disability, psychological impairment, disease activity, physician ratings, C-reactive protein) will be assessed at baseline and 1-month, 3-month, and 12-month follow-ups, and potential mediators (self-efficacy, coping skill use, emotional approach coping) will be assessed via 30-day daily diary recordings prior to each assessment. Analyses will a) test whether the integrated treatment leads to better outcomes than either ED or CST alone; b) directly compare the efficacy of ED alone and CST alone; and c) compare each treatment with a control condition. Process measures will determine whether the integrated treatment enhances the content of patients' emotional disclosure and their participation in CST, and analyses of mediators will indicate whether the interventions have unique or common pathways. This research is key to the goal of developing theoretically-grounded, highly efficacious, and easily implemented self-management strategies to improve adjustment of people with RA and other pain conditions.

描述（由申请人提供）：两种自我管理干预措施有望改善风湿关节炎患者的健康和调整（RA）：书面情感披露（ED）和应对技能培训（CST）。这些方法已经分开演变，没有被比较，并且与CST整合的干预措施可能比单独使用的干预措施更有效。拟议的研究结合了两个研究团队的专业知识，以对ED和CST对RA的人进行综合和单独影响的随机，对照试验。 RA（n = 280）的成年人将在2 x 2阶乘设计中随机分为四个治疗组之一。一个因素是ED的六个会议（关于压力，RA和应对选项）或其匹配的控制，中性写作。第二个因素是治疗师提供的CST的6次会议（教授六个疼痛和压力应对技巧）或其匹配的控制，提供护士提供的关节炎教育。因此，这4种治疗方法是：a）综合ED / CST； b）ED（+关节炎教育）； c）CST（+中性写作）； D）控制（中性写作 +关节炎教育）。将在基线和1个月，3个月和12个月的随访以及潜在的调解人（自我效能，应对技能使用，情感方法应对评估）时，将评估全面评估一系列措施（疼痛，身体残疾，心理障碍，疾病活动，医师评级，C反应蛋白）的全面评估。分析将a）测试综合治疗是否会导致比单独使用或CST更好的结果； b）直接比较单独使用ED和CST的功效； c）将每种处理与对照条件进行比较。过程指标将确定综合治疗是否可以增强患者情绪披露的含量及其参与CST的含量，并且对介体的分析将指示干预措施是否具有独特的或常见的途径。这项研究是开发理论上的，高效且易于实施的自我管理策略，以改善RA和其他疼痛状况的人的调整的关键。