Jointstrong intervention for juvenile arthritis

幼年关节炎的联合强干预

• 批准号: 7599595
• 负责人: MICHAEL Andrew RAPOFF
• 金额: $ 16.17万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7599595
• 关键词: 12 year old; Address; Adolescent; Adult; Affect; Aftercare; Age; Behavioral; CD-ROM; Caring; Child; Childhood; Chronic; Chronic Childhood Arthritis; Chronic Headaches; Clinical Trials; Cognitive; Computers; Control Groups; Critiques; Data; Development; Diagnosis; Disease; Family; Fatigue; Frequencies; Funding; Gender; Generic Drugs; Grant; Health Care Costs; Hour; Internet; Intervention; Kansas; Measures; Medical; Medical center; Minimal Contact Treatment; Moods; National Institute of Arthritis and Musculoskeletal and Skin Diseases; National Institute of Neurological Disorders and Stroke; Pain; Pain management; Participant; Patients; Pharmacological Treatment; Pilot Projects; Quality of life; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recurrent pain; Relative (related person); Reporting; Research Priority; Rheumatism; Stress; Stressful Event; Symptoms; Technology; Testing; Universities; Waiting Lists; base; biopsychosocial; chronic pain; cognitive behavior therapy; coping; cost; diaries; disability; follow-up; functional disability; improved; innovation; programs; response

DESCRIPTION (provided by applicant): This R21 pilot study addresses behavioral and biopsychosocial research priorities of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) to conduct studies of non-pharmacological interventions, including technology-based interventions, for chronic symptoms such as pain. Chronic or recurrent pain is central feature of juvenile arthritis (JA). About 25 to 30 percent report moderate to severe pain and the great majority of children with JA report at least some pain lasting from 30 minutes to 24 hours a day, with a mean of 4.3 hours per day. In addition, long-term follow up shows that the adults who were diagnosed with JA report significantly greater pain, fatigue, and disability relative to gender-matched healthy cases. Thus, for many children with JA pain is a significant problem that persists into adulthood and is associated with significant disability. And, in spite of advancements in pharmacological treatments foonic childhood pain. The primary aim of this application is to develop and pilot test "Jointstrong," an adjunctive computer-based cognitive-behavioral intervention for pain in children with JA. This pilot study will randomly assign 36 children, 8 to 12 years with JA to the Jointstrong program or a wait-list control group. Daily diary measures of pain intensity, duration, and frequency, mood and stress, as well as quality of life measures will be taken during two-week intervals at baseline, immediate post-treatment, and 3-month follow-up. Hypotheses are that children who receive the Jointstrong in combination with standard medical care will demonstrate greater improvement on the pain, mood and stress, and quality of life measures than children in a standard medical care (wait-list) control group. If this pilot study is successful, a larger R01 clinical trial will be proposed to further validate the Jointstrong program. PROJECT NARRATIVE: The development of computer-based adjunctive pain management programs for children with chronic pain, such as JA, can be cost-effective and easily disseminated to patients and families via CD-ROM programs or on the Web. These programs can also reduce health care costs and functional disability and improve the quality of life for children with chronic or recurrent pain.

描述（由申请人提供）：这项 R21 试点研究涉及国家关节炎、肌肉骨骼和皮肤疾病研究所 (NIAMS) 的行为和生物心理社会研究重点，以针对疼痛等慢性症状开展非药物干预措施（包括基于技术的干预措施）。慢性或复发性疼痛是幼年关节炎 (JA) 的主要特征。大约 25% 至 30% 的儿童报告有中度至重度疼痛，绝大多数患有 JA 的儿童报告至少有一些疼痛，每天持续 30 分钟到 24 小时，平均每天 4.3 小时。此外，长期随访显示，与性别匹配的健康病例相比，被诊断患有 JA 的成年人的疼痛、疲劳和残疾明显更大。因此，对于许多患有 JA 的儿童来说，疼痛是一个持续到成年并与严重残疾相关的重大问题。而且，尽管药物治疗取得了进步，但儿童期疼痛仍然存在。该应用程序的主要目的是开发并试点测试“Jointstrong”，这是一种基于计算机的认知行为辅助干预方法，用于治疗 JA 儿童的疼痛。这项试点研究将随机将 36 名患有 JA 的 8 至 12 岁儿童分配到 Jointstrong 计划或等候名单对照组。将在基线、治疗后立即和 3 个月随访期间每隔两周进行疼痛强度、持续时间和频率、情绪和压力以及生活质量的每日日记测量。假设接受联合强与标准医疗护理相结合的儿童将比标准医疗护理（候补名单）对照组的儿童在疼痛、情绪和压力以及生活质量方面表现出更大的改善。如果这项试点研究成功，将提出更大规模的R01临床试验，以进一步验证玖强计划。项目叙述：为患有慢性疼痛（例如 JA）的儿童开发基于计算机的辅助疼痛管理程序可以具有成本效益，并且可以通过 CD-ROM 程序或在网络上轻松传播给患者和家庭。这些计划还可以降低医疗保健费用和功能障碍，并改善患有慢性或复发性疼痛的儿童的生活质量。