Health Promotion and Quality of Life in Chronic Illness

慢性病患者的健康促进和生活质量

• 批准号: 6917683
• 负责人: Alexa Stuifbergen
• 金额: $ 33.41万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-30 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6917683
• 关键词: behavioral /social science research tag; chronic disease /disorder; clinical research; comorbidity; disabling disease; functional ability; health behavior; health education; human subject; longitudinal human study; multiple sclerosis; nursing models; outcomes research; patient care management; patient oriented research; psychological aspect of aging; quality of life

DESCRIPTION (provided by applicant): During the last decade substantial research efforts have resulted in significant progress in defining the pathologic changes of MS, using MRI techniques to evaluate disease progress, and developing disease modifying medications (Joy & Johnston, 2001). However, we still know very little about the natural history of MS over time and can offer persons with MS little guidance about the likely outcome of their disease or ways that their individual behaviors might influence the trajectory of disease-related limitations and disability. Findings from the current study (2R01NRO3195 06-10) indicate that the trajectory of change over time (7 years) in MS-related functional limitations and quality of life outcomes (perceived quality of life, depression, secondary conditions) is slow but significant and in a direction reflecting increased limitations and secondary conditions. Findings from the current study support the hypothesis that health promoting behaviors are able to mediate the effects of illness related limitations on perceived quality of life in community residing persons with MS. The primary purpose of this competing continuation is to identify psychosocial and behavioral factors that may influence the trajectory of functional limitations, disability and quality of life in persons with MS through continuing longitudinal follow-up of the existing sample (N=565). The explanatory model of health promotion and quality of life in chronic illness that was developed, refined and validated over 10 years of earlier work (R29NR03195 and 2R01NR03195) will be integrated with the well known disablement process model (Verbrugge & Jette, 1994) to obtain a better understanding of factors affecting the trajectory of MS related functional limitations and disability and how these variables are subsequently related to changes in quality of life. We will also explore how perceptions of aging and co-morbid conditions commonly experienced with aging may influence the progression of functional limitations and disability over time as this sample (average age 54) ages with a chronic disabling condition. We will enhance the methods used in our current study by incorporating performance-based measures of functional limitation to obtain a more complete understanding of varying clinical expressions of MS limitations over time. Longitudinal data will be analyzed with hierarchical linear models (HIM) and structural equation modeling techniques.

描述（由申请人提供）：在过去十年中，大量的研究工作在定义MS的病理变化、使用MRI技术评估疾病进展以及开发疾病缓解药物方面取得了重大进展（Joy &约翰斯顿，2001）。然而，我们仍然对MS的自然史知之甚少，并且可以为MS患者提供关于其疾病可能结果或其个人行为可能影响疾病相关限制和残疾轨迹的指导。当前研究（2 R 01 NRO 3195 06-10）的结果表明，MS相关功能限制和生活质量结局（感知生活质量、抑郁、继发性疾病）随时间（7年）的变化轨迹缓慢但显著，并且在反映限制和继发性疾病增加的方向上。目前研究的结果支持这一假设，即健康促进行为能够调解疾病相关限制对社区MS患者感知生活质量的影响。这种竞争性延续的主要目的是确定可能影响功能限制轨迹的心理社会和行为因素，通过对现有样本（N=565）的持续纵向随访，研究MS患者的残疾和生活质量。在10年的早期工作中开发、完善和验证的慢性病健康促进和生活质量的解释模型（R29 NR 03195和2 R 01 NR 03195）将与众所周知的禁用过程模型集成（Verbrugge & Jette，一九九四年）更好地了解影响MS相关功能限制和残疾轨迹的因素，以及这些变量随后如何与生活质量的变化。我们还将探讨如何老化和共病条件的看法，通常与老化可能会影响功能限制和残疾的进展随着时间的推移，因为这个样本（平均年龄54岁）的年龄与慢性致残性疾病。我们将通过纳入基于性能的功能限制措施来增强我们当前研究中使用的方法，以更全面地了解MS限制随时间变化的临床表现。将采用分层线性模型（HIM）和结构方程建模技术分析纵向数据。