Everyday Quality of Life in Blacks and Whites with Osteoarthritis

患有骨关节炎的黑人和白人的日常生活质量

• 批准号: 8339990
• 负责人: PATRICIA A. PARMELEE
• 金额: $ 48.01万
• 依托单位: UNIVERSITY OF ALABAMA IN TUSCALOOSA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8339990
• 关键词: Activities of Daily Living; Address; Adult; Affect; Affective; Affective Symptoms; African American; Age; American; Arthritis; Attention; Behavioral; Biological; Biological Factors; Characteristics; Chronic Disease; Cognitive; Data; Degenerative polyarthritis; Diagnosis; Disease; Distress; Elderly; Emotional; Epidemiology; Health; Health Care Costs; Health Status; Individual; Knee; Knee Osteoarthritis; Leisure Activities; Longitudinal Studies; Measures; Methods; Modeling; Moods; Not Hispanic or Latino; Obesity; Pain; Participant; Patient Self-Report; Pattern; Performance; Personal Satisfaction; Personality; Persons; Physicians; Population; Prevalence; Procedures; Process; Psychological Factors; Quality of life; Race; Research; Risk; Sampling; Shapes; Site; Source; Symptoms; Telephone; Textiles; Time; Variant; Work; actigraphy; aged; biopsychosocial; coping; disability; disease characteristic; emotional distress; experience; functional decline; functional disability; indexing; insight; optimism; psychologic; racial and ethnic disparities; racial/ethnic difference; response; sex; social

DESCRIPTION (provided by applicant): This research examines relationships among pain, everyday activities and mood states, and long-term quality of life among African American (AA; Black) and non-Hispanic White (NHW; White) older adults with osteoarthritis (OA) of the knee. Recent evidence suggests considerable divergence in the experience and effects of this potentially very debilitating disorder among AAs and NHWs. Unfortunately, there has been little in-depth research on racial/ethnic (R/E) differences previous work on racial/ethnic (R/E) disparities in basic experience of OA symptoms, and in the emotional impact of those symptoms and related disability. This research addresses that gap in a longitudinal study of OA pain, functional disability and emotional well-being of AAs and NHWs. Working from a biopsychosocial model, we shall use functional assessments, self-reports, and real-time assessments of activities, symptoms and mood states to construct a comprehensive view of how OA affects physical and emotional functioning. Specific aims are (1) to describe racial/ethnic differences in associations among pain, disability, and emotional well-being of persons with OA of the knee; (2) to identify origins of those differences in (a) biological factors such as disease process and general health, (b) social factors such as demographic characteristics, and (ii) psychological factors, including stable personal characteristics and transitory (within-day) affective, cognitive and behavioral responses to knee symptoms; (3) to use experience sampling methods (ESM) and actigraphy to investigate how racial/ethnic differences in global associations among pain, functional limitations and emotional distress are reflected in the daily lives of OA sufferers, and (4) to explore how the interplay of transitory (within-day) symptoms, activities and mood states influences long-term physical and emotional well-being. These aims will be achieved in a 5-year, multi- site project examining cross-sectional and longitudinal associations among demographic and health characteristics, OA-related pain and disability, restriction of everyday activities, and emotional well-being. A sample of 220 AA and 220 NHW adults aged 50+ with physician-diagnosed OA of the knee will complete a comprehensive baseline assessment tapping biological, psychological and social vulnerability to OA pain and its effects; objective functional limitations; pain; activity restriction, and emotiona distress. Immediately post- baseline, participants will complete a 7-day ESM procedure comprising actigraphic assessment of activity levels along with 4 daily telephone contacts to assess current symptoms, activities, and moods. One year later, participants will repeat all measures, including the ESM component, to capture changes in overall physical and emotional well-being as well as patterns of daily activity and moods. Resulting data will offer unprecedented insight into the global factors that differentiate AAs' and NHWs' experience of OA symptoms, and how daily experiences are concatenated to influence longer-term physical and emotional well-being. PUBLIC HEALTH RELEVANCE: Osteoarthritis (OA) is the most common chronic illness and the leading cause of pain and disability among older adults. As the population ages, prevalence of OA is rising sharply; this, in turn, portends rising rates of disability and health care costs. Osteoarthritis's characteristic pain and functional limitations place persons at increased risk of significant emotional distress; that distress may, in turn, fuel OA pain and hasten functional decline. There are clear differences in the epidemiology of OA among African American (AA) and non-Hispanic White (NHW) older adults, but surprisingly little is known about racial/ethnic disparities in the functional and emotional effects of OA. This study fills that gap by examining how OA of the knee affects everyday activities and emotional well-being of older AAs and NHWs, and how those effects change over a one-year period.

描述（由申请人提供）：本研究检查了患有膝关节骨关节炎（OA）的非裔美国人（AA;黑人）和非西班牙裔白色人（NHW;白色）老年人的疼痛、日常活动和情绪状态与长期生活质量之间的关系。最近的证据表明，这种潜在的非常衰弱的疾病的经验和影响之间的AA和NHW相当大的分歧。不幸的是，很少有深入的研究种族/民族（R/E）的差异，以前的工作种族/民族（R/E）的差异，在基本经验的OA症状，并在情绪上的影响，这些症状和相关的残疾。本研究解决了OA疼痛，功能障碍和情绪健康的AA和NHW的纵向研究的差距。从生物心理社会模型出发，我们将使用功能评估、自我报告以及活动、症状和情绪状态的实时评估来构建OA如何影响身体和情绪功能的全面视图。具体目标是（1）描述膝关节骨性关节炎患者疼痛、残疾和情感健康之间的种族/民族差异;（2）确定这些差异的起源（a）生物因素 例如疾病过程和一般健康状况，（B）社会因素，例如人口统计学特征，和（ii）心理因素，包括稳定个人特征和暂时的（日内）对膝关节症状的情感、认知和行为反应;（3）使用经验抽样方法（ESM）和腕动记录仪来研究种族/民族差异在疼痛，功能限制和情绪困扰反映在OA患者的日常生活中;（4）探讨短暂（一天内）症状、活动和情绪状态的相互作用如何影响长期的身体和情绪健康。这些目标将在一个为期5年的多中心项目中实现，该项目检查人口统计学和健康特征、OA相关疼痛和残疾、日常活动限制和情感健康之间的横截面和纵向关联。220名AA和220名NHW年龄在50岁以上、经医生诊断为膝关节OA的成年人样本将完成一项综合基线评估，评估OA疼痛及其影响的生物学、心理学和社会脆弱性;客观功能限制;疼痛;活动限制和情绪困扰。基线后，受试者将立即完成为期7天的ESM程序，包括活动水平的活动记录评估沿着4次每日电话联系，以评估当前症状、活动和情绪。一年后，参与者将重复所有措施，包括ESM部分，以捕捉整体身体和情绪健康以及日常活动和情绪模式的变化。由此产生的数据将提供前所未有的洞察力，以区分AAs和NHWs的OA症状体验的全球因素，以及日常体验如何连接起来影响长期的身体和情绪健康。 公共卫生相关性：骨关节炎（OA）是最常见的慢性疾病，也是老年人疼痛和残疾的主要原因。随着人口老龄化，OA的患病率急剧上升;这反过来又预示着残疾率和医疗保健费用的上升。骨关节炎的特征性疼痛和功能限制使人们处于显著情绪困扰的风险增加;这种困扰可能反过来加剧OA疼痛并加速功能衰退。在非洲裔美国人（AA）和非西班牙裔白色（NHW）老年人中，OA的流行病学存在明显差异，但令人惊讶的是，对OA的功能和情感影响的种族/民族差异知之甚少。这项研究通过检查膝关节OA如何影响老年AA和NHW的日常活动和情绪健康，以及这些影响在一年内如何变化来填补这一空白。