Nursing Management of IBS: Improving Outcomes

描述：（由申请人提供）拟定研究是一项竞争性研究 研究者的NINR资助的题为“IBS的护理研究： 改善结果。“目前的研究直接建立在研究人员的 一项名为个体化综合治疗的非药物干预研究 自我管理，以减少胃肠道症状，提高妇女的生活质量 (ages 20-45）与IBS。在这项研究中，患有IBS的女性接受了 全面的自我管理计划有显着降低GI 症状、心理困扰和生活质量的改善， 在常规护理和简短教育干预小组中的妇女。尽管 与干预相关的积极结果，结果可能不是 可推广至围绝经期和绝经后年龄的男性或女性。 拟议研究的目的是：1）测试 面对面的个性化综合自我管理计划和 与男性常规护理组相关的仪器电话版本， 女性IBS结果测量将是胃肠道症状，睡眠障碍， 心理困扰、疾病影响和健康相关生活质量 （HRQOL）和2）探索GI症状改善与 减少心理困扰，通过前瞻性报告测量， 焦虑和抑郁，以及全球心理健康的回顾性报告 痛苦和探索之间的关系减少生理唤醒 通过测量两人的基础儿茶酚胺水平和基础皮质醇水平 和妇女一项三组随机纵向随访临床试验 将用于测试面对面（n=60）与电话的有效性 综合自我管理计划（n=60），相对于常规护理对照 对照组（n=60）。将在基线评估期间测量结局指标 阶段以及随机化后3、6和12个月。本研究 重要的是，因为与IBS患者一起工作的卫生保健提供者 挑战在于潜在的病理学没有很好地定义， 有限的药物治疗。迄今为止，非药物干预 由于样本量小，缺乏对性别的关注， 只有少数几个国家采取了长期后续行动。

DESCRIPTION: (provided by applicant) The proposed study is a competitive renewal of the investigators' NINR funded study entitled "nursing Study of IBS: Improving Outcomes." The current study builds directly on the investigator's study of a non-pharmacologic intervention entitled individualized comprehensive self-management to reduce GI symptoms and enhance quality of life in women (ages 20-45) with IBS. In that study women with IBS who received a comprehensive self-management program had significant reductions in GI symptoms, psychological distress, and improved quality of life compared to women in the usual care and brief educational intervention groups. Despite the positive outcomes associated with the intervention, the results may not be generalizable to men or to women of peri-menopausal and post-menopausal age. The aims of the proposed study are to 1) test the effectiveness of the face-to-face individualized comprehensive self-management program and a telephone version of the instrument relative to a usual care group in men and women with IBS. Outcome measures will be GI symptoms, sleep disturbance, psychological distress, sickness impact, and health related quality of life (HRQOL) and 2) explore the relationship between GI symptom improvement and a decrease in psychological distress as measured by prospective reports of anxiety and depression, and retrospective reports of global psychological distress and explore the relationship between decrease in physiological arousal as measured by basal catecholamine levels and basal cortisol levels in both men and women. A three group randomized clinical trial with longitudinal follow-up will be used to test the effectiveness of face to face (n=60) versus telephone comprehensive self-management program (n=60), relative to a usual care control group (n=60). Outcome measures will be measured during the baseline assessment phase, and at 3, 6, and 12 months following randomization. This study is important because health care providers working with patients with IBS are challenged in that the underlying pathology is not well defined and there are limited drug treatments available. To date, non-pharmacological intervention trials have been limited by small sample size, lack of attention to gender specific issues, and only a few included long-term follow-ups.