HRT Decision Support for Women with Mobility Impairment

为行动不便的女性提供 HRT 决策支持

• 批准号: 6664779
• 负责人: HEATHER A BECKER
• 金额: $ 14.79万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2006-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6664779
• 关键词: behavioral /social science research tag; clinical research; counseling; decision making; disease /disorder proneness /risk; education evaluation /planning; female; health behavior; health education; health services research tag; hormone therapy; human middle age (35-64); human subject; menopause; nursing intervention; outcomes research; person with disability; preference; psychological stressor; psychological values; publications; satisfaction; vasomotion; women's health

DESCRIPTION (provided by applicant): Healthy People 2010, the American Nurses Association, and the American College of Physicians have all recommended that mid-life women be counseled about the risks and benefits of hormone replacement therapy (HRT). Conflicting scientific evidence about long-term outcomes has made HRT use controversial. Menopausal women, however, cannot wait until the scientific evidence becomes more decisive to make this decision. In such an uncertain decision environment, nursing interventions are most needed to address the unsure and/or value sensitive nature of the risks and benefits associated with this decision (O'Connor, 1988). Women with mobility impairments face special challenges regarding HRT use. Because they enter menopause with decreased weight bearing and aerobic activity histories, they may be at greater risk for Osteoporosis and cardiovascular disease. Women who experience temperature fluctuations as part of their disability may find the Vasomotor instability that can occur during menopause particularly troublesome. While HRT might be particularly beneficial to these women, they may also be at increased risk of thrombosis. Consequently, existing information about the risks and benefits associated with HRT use must be tailored to the special needs of this population. Previous research has indicated that, following use of a theoretically based decision support intervention, non-disabled women increased their HRT knowledge, congruence between personal values and choices, satisfaction with the decision, and decreased their decisional conflict (O'Connor, et al., 1998). The aim of this study is to test an adapted version of this intervention, designed to assist women with mobility impairments in making informed choices about HRT use. Two hundred mid-life women with mobility impairments will be randomly assigned either to a decision support intervention, which has been adapted to their special needs, or to a standard educational pamphlet. Multiple Analysis of Variance will be used to assess changes in decision outcomes from pre-intervention to immediate post-intervention and 6 months following the intervention. Findings from this study will assist nurses and other providers to counsel women with mobility impairments about key health care decisions during menopause.

描述（由申请人提供）：2010年健康人，美国护士协会和美国医师学院都建议中年妇女接受有关激素替代疗法（HRT）的风险和益处的咨询。关于长期结果的科学证据使HRT的使用备受争议。然而，单身女性不能等到科学证据变得更具决定性时再做决定。在这样一个不确定的决策环境中，最需要护理干预来解决与该决策相关的风险和收益的不确定性和/或价值敏感性（奥康纳，1988年）。行动不便的妇女在使用HRT方面面临特殊挑战。因为她们进入更年期时，体重和有氧活动史减少，她们患骨质疏松症和心血管疾病的风险更大。 作为残疾的一部分，经历温度波动的妇女可能会发现更年期期间可能发生的血管不稳定特别令人烦恼。虽然HRT可能对这些女性特别有益，但他们也可能增加血栓形成的风险。因此，关于HRT使用相关风险和益处的现有信息必须针对这一人群的特殊需求进行调整。先前的研究表明，在使用基于理论的决策支持干预后，非残疾妇女增加了她们的HRT知识、个人价值观和选择之间的一致性、对决策的满意度，并减少了她们的决策冲突（奥康纳等人，1998年）。本研究的目的是测试这种干预的适应版本，旨在帮助行动不便的妇女在知情的选择HRT的使用。200名行动不便的中年妇女将被随机分配到一个决策支持干预，这已经适应了他们的特殊需要，或一个标准的教育小册子。将使用多元方差分析评估从干预前到干预后即刻和干预后6个月的决策结果变化。这项研究的结果将有助于护士和其他提供者为更年期期间行动不便的妇女提供有关关键医疗保健决策的咨询。