Longitudinal study of cognition, health literacy, and self-care in COPD patients

COPD患者认知、健康素养和自我护理的纵向研究

• 批准号: 8490418
• 负责人: Alex D Federman
• 金额: $ 77.04万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-18 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8490418
• 关键词: Acute; Acute Disease; Address; Adherence; Adult; Affect; Attention; Behavior; Caregivers; Caring; Chicago; Chronic; Chronic Disease; Chronic Obstructive Airway Disease; Chronically Ill; Cognition; Cognitive; Communication; Data; Disease; Disease Management; Disease Progression; Elements; Functional disorder; Health; High Prevalence; Home environment; Hospitalization; Hospitals; Hypoxemia; Impaired cognition; Individual; Information Services; Inhalators; Instruction; Intervention; Interview; Longitudinal Studies; New York City; Outcome; Patients; Physicians; Play; Policies; Primary Health Care; Process; Research; Resources; Role; Science; Self Care; Self Management; Severity of illness; Short-Term Memory; Social support; Symptoms; Techniques; Time; Vulnerable Populations; base; cognitive function; disorder control; executive function; health literacy; improved; inner city; innovation; insight; loved ones; medication compliance; processing speed; skills; socioeconomics; therapy design

PROJECT SUMMARY The overall objective of this study is to investigate longitudinal associations between cognition, health literacy (HL), and self-care in patients with chronic obstructive pulmonary disease (COPD), and determine whether social support from informal caregivers mitigates these associations. Cognitive function, a major component of HL, declines progressively in many COPD patients. HL might change over time as well, progressively altering COPD patients' ability to understand and use health information. However, longitudinal data on HL are not available. It is also unknown whether acute COPD exacerbations temporarily worsen cognition and HL, as might be expected owing to hypoxemia. Informal caregivers frequently help COPD patients manage their health at home, but little is known about the extent to which social support compensates for the HL and cognitive limitations of these patients, and whether caregivers' own problems of HL limit their ability to help others manage their chronic disease. Elucidating these issues could provide important data for developing interventions aimed at both patients and caregivers to overcome HL and cognition barriers to successful COPD management, and perhaps to other chronic diseases as well. Accordingly, the Specific Aims of this study are to (1) Examine longitudinally the trajectory of HL among patients with COPD, both as the disease progresses over time and following acute exacerbations; (2) Assess the association between HL, and it subcomponents, and specific self-management behaviors in patients with COPD, such as medication adherence and inhaler technique; (3) Evaluate the mitigating role of support from informal caregivers and caregivers' HL on the relationship between patients' HL and COPD self-management. We will address these aims by conducting a study of 400 English and Spanish-speaking adults with COPD from two socioeconomically and racially diverse inner-city primary care practices in New York City, NY and Chicago, IL. Patients will be followed for 2 years to collect data on HL, cognitive function, COPD symptoms and self-management behaviors. These data will also be assessed at the time of a hospital discharge for COPD exacerbation and one week later. Additionally, 100 informal caregivers of a subset of patients with COPD will be interviewed to determine their HL. This study is innovative in its longitudinal examination of the effects of HL and cognitive function and the potential mitigating role of caregiver support and caregiver HL. It will expand our understanding of the mechanisms through which HL and cognition influence COPD self-management, offering us an opportunity to design interventions to improve outcomes in a highly vulnerable population.

项目摘要 这项研究的总体目的是研究认知，健康素养之间的纵向关联 （HL）和患有慢性阻塞性肺疾病（COPD）患者的自我保健，并确定是否是否 非正式护理人员的社会支持减轻了这些关联。认知功能，主要组成 HL，在许多COPD患者中逐渐下降。 HL可能会随着时间而改变，逐步改变 COPD患者了解和使用健康信息的能力。但是，HL上的纵向数据不是 可用的。急性COPD是否暂时恶化认知和HL，因为 可能由于低氧血症而被预期。非正式护理人员经常帮助COPD患者管理他们的 在家中的健康，但对社会支持弥补HL和HL的程度知之甚少 这些患者的认知限制，以及护理人员自己的HL问题是否限制了他们的帮助能力 其他人管理慢性疾病。阐明这些问题可以为开发提供重要数据 针对患者和护理人员克服HL和成功COPD的认知障碍的干预措施 管理，也许也是其他慢性疾病。因此，这项研究的具体目的是 （1）在COPD患者中纵向检查HL的轨迹，既随着疾病的进展 随着时间的流逝和急性加重； （2）评估HL和IT亚组件之间的关联， 以及COPD患者的特定自我管理行为，例如药物依从性和吸入器 技术; （3）评估非正式护理人员和护理人员HL对支持的缓解作用 患者HL与COPD自我管理之间的关系。我们将通过执行 研究来自两个社会经济和种族多样的400名英语和西班牙语的成年人 纽约市纽约市和伊利诺伊州芝加哥市的市中心初级保健实践。患者将被追踪2年 收集有关HL，认知功能，COPD症状和自我管理行为的数据。这些数据也将 在医院出院时，请评估COPD加重和一周后的评估。另外，100 将采访一部分COPD患者的非正式护理人员，以确定其HL。这项研究是 在对HL和认知功能的影响以及潜在缓解的影响的纵向检查中的创新性 护理人员支持和护理人员HL的作用。它将扩展我们对通过的机制的理解 HL和认知会影响COPD的自我管理，为我们提供了设计干预措施的机会 改善高度脆弱人群的结果。