Functional recovery in spinal stenosis: Understanding the activated patient

描述(由申请人提供)：腰椎手术后的功能恢复可能会受到参与术后物理治疗的中介效应的影响。这种参与以及反过来的功能恢复，可能会受到一系列生物医学和心理社会决定因素的影响。目前这项研究计划的长期目标是了解积极的心理力量和弹性在背痛手术患者的功能恢复、疼痛减轻和生活质量改善方面的相互作用。 当前的心理学理论关注的是个体的优势和资源。这些资源是 包括如果患者激活的概念(Hibbard，et.艾尔2004年)。一个被激活的病人有能力， 知识和动力，成为他们健康的有效管理者，并积极参与他们的医疗保健团队。为此，目前建议的具体目标是确定患者激活测量(PAM)的心理测量学特性；确定PAM的结构效度；以及确定由PAM评估的基线患者激活对参与术后物理治疗的影响。 为了实现这些具体目标，我们将招募65名接受腰椎手术的患者。该队列将以前瞻性的方式在手术前和手术后进行评估。这项评估将包括收集有关生物、医学和心理社会决定因素以及健康行为的信息。除了达到这些目标外，目前的研究还将为未来的项目提供信息。这将通过以下方式实现：制定和完善在这一群体中进行研究的招募方法，测试和评估新的健康行为报告机制，并为样本量计算和权力估计提供合理的估计。

DESCRIPTION (Provided by the Applicant): Functional recovery following lumbar spine surgery may be influenced by the intermediary effect of participation in post-operative physical therapy. This participation and, in turn, functional recovery, may be affected by a host of bio-medical and psycho-social determinants. The long-term goal of the current research program is to understand the interplay of positive psychological strengths and resiliencies on recovery of function, reduction of pain, and improvement in quality of life among individuals undergoing surgery for back pain. Current psychological theory focuses on an individual's strengths and resources. These resources are included if the concept of patient activation (Hibbard, et. al. 2004). An activated patient has the skills, knowledge, and motivation to be an effective manager of their health and an active participant in their health care team. To this end, the specific aims of the current proposal are to determine the psychometric properties of the Patient Activation Measure (PAM); to determine the construct validity of the PAM; and to determine the influence of baseline patient activation as assessed by the PAM on participation in post-operative physical therapy. To achieve these specific aims, we will enroll a cohort of 65 individuals undergoing lumbar spine surgery. This cohort will be assessed pre-operatively and post-operatively in a prospective manner. This assessment will include collection of information regarding bio-medical and psycho-social determinants and health behavior. In addition to meeting these aims, the current research will inform future projects. This will be achieved through the development and refinement of recruitment methods for research in this population, the testing and evaluation of novel reporting mechanisms for health behavior, and the provision of reasonable estimates for sample size calculations and power estimates.