Grief and health-related quality of life in WTCHR Survivors: Associations with bereavement, trauma exposures, and mental and physical health conditions

WTCHR 幸存者的悲伤和与健康相关的生活质量：与丧亲之痛、创伤经历以及身心健康状况的关联

• 批准号: 10535968
• 负责人: Stephen Cozza
• 金额: $ 50万
• 依托单位: HENRY M. JACKSON FDN FOR THE ADV MIL/MED
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10535968
• 关键词: Grief; health; related; quality; life

Project Summary Survivors of sudden and violent deaths, such as those that occurred on 9/11, are at higher risk for prolonged grief disorder (PGD), in response to both that death and subsequent deaths. Despite World Trade Center Health Registry (WTCHR) Survivors’ high rates of knowing someone who died on 9/11, there has been minimal study of bereavement, trauma, and grief and their effects on health-related quality of life (HRQoL), including cognitive functioning, in this population while accounting for the effects of gender, race, and ethnicity. This proposal will first determine grief severity and the presence of self-reported threshold PGD in a representative sample of English- and Spanish-speaking WTCHR Survivors. Study findings will provide a greater understanding of grief severity/PGD among gender, ethnic, and racial groups and help to ensure that public health efforts reflect the needs of the diverse WTCHR Survivor community. This proposal will also examine the associations between bereavement and trauma with current grief severity, including PGD. Using existing WTCHR data regarding 9/11-related bereavement and trauma and newly- collected information pertaining to subsequent bereavement and trauma, as well as current grief, we will examine the complex inter-relationships among these variables to outline pathways of risk. We will also examine the impact of grief and these factors on HRQoL by determining how risk pathways and associations described above (bereavement burden, trauma burden, grief severity/PGD) extend to HRQoL, while also taking into account the effects of physical and mental health burden. As bereavement has been associated with impairment in various cognitive functions that affect daily functioning which have also been associated with quality of life, and cognitive impairments have been associated with WTC-exposure, we plan to assess cognitive difficulties as an additional aspect of HRQoL. The last aim of this project addresses reports that treatments for PTSD, depression, and anxiety disorder have not been readily available or accessed by WTCHR participants. Therefore, we will determine the extent to which individuals who are at risk for PGD are ready and able to access grief support within the community, and are satisfied with the support they receive. This proposal brings together an experienced multidisciplinary team of collaborators from the Center for the Study of Traumatic Stress at Uniformed Services University, the Center for Prolonged Grief at Columbia University, the WTCHR, and Voices of September 11, Inc., which has an established history, familiarity, and rapport with the 9/11 survivor community, as well as established working relationships with one another.

项目概要 突然和暴力死亡（例如 9/11 事件）的幸存者面临长期死亡的较高风险。 悲伤症（PGD），针对那次死亡和随后的死亡。尽管世贸中心 健康登记处 (WTCHR) 幸存者认识 9/11 死者的比例很高， 对丧亲、创伤和悲伤及其对健康相关生活质量 (HRQoL) 的影响进行了极少的研究， 包括该人群的认知功能，同时考虑性别、种族和民族的影响。 该提案将首先确定悲伤的严重程度以及自我报告阈值 PGD 的存在 讲英语和西班牙语的 WTCHR 幸存者的代表性样本。研究结果将提供 更好地了解性别、民族和种族群体中悲伤的严重程度/PGD，并有助于确保 公共卫生工作反映了 WTCHR 幸存者社区的多元化需求。 该提案还将研究丧亲之痛和创伤与当前悲伤严重程度之间的关联， 包括胚胎植入前诊断（PGD）。使用有关 9/11 相关丧亲和创伤的现有 WTCHR 数据以及最新的数据 收集有关随后的丧亲和创伤以及当前悲伤的信息，我们将 检查这些变量之间复杂的相互关系，以概述风险的途径。我们还将 通过确定风险路径和关联来检查悲伤和这些因素对 HRQoL 的影响 上述（丧亲负担、创伤负担、悲伤严重程度/PGD）延伸至 HRQoL，同时也 考虑到身心健康负担的影响。由于丧亲之痛已与 影响日常功能的各种认知功能受损，这也与 与生活质量有关，并且认知障碍与世贸中心暴露有关，我们计划评估 认知困难是 HRQoL 的另一个方面。该项目的最后一个目标是解决以下报告 创伤后应激障碍（PTSD）、抑郁症和焦虑症的治疗方法尚未获得或无法获得 世界人权中心参与者。因此，我们将确定有 PGD 风险的个人的程度 准备好并能够获得社区内的悲伤支持，并对他们收到的支持感到满意。 该提案汇集了来自中心的经验丰富的多学科合作者团队 军警大学、哥伦比亚长期悲伤中心的创伤应激研究 University、WTCHR 和 Voices of September 11, Inc.，该公司拥有悠久的历史、熟悉度和 与 9/11 幸存者社区保持融洽关系，并相互建立工作关系。