Functional recovery in lumbar spine surgery: Influence of a brief Health Behavior

腰椎手术中的功能恢复：短暂健康行为的影响

• 批准号: 7937100
• 负责人: RICHARD L. SKOLASKY
• 金额: $ 23.95万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7937100
• 关键词: Functional; recovery; lumbar; spine; surgery

DESCRIPTION (provided by the applicant): Spine surgery is one of the most common and costly inpatient procedures in the United States with rates increasing dramatically during the past two decades, especially among those greater than 60 years of age or with degenerative conditions of the spine. Recovery following spine surgery is highly variable and cannot be explained by traditionally studied factors. The Institute of Medicine (IOM) issued a challenge to the American health care system to improve the patient-centeredness of healthcare. This challenge arises from the fact that patient-centered care has a profound impact on the way that healthcare is planned, delivered, and evaluated. Recent evidence supports the hypothesis that patient-centered interventions improve outcomes through empowerment of the individual patient. This empowerment can be achieved through increases in self-efficacy and patient activation. This approach is a central tenet of several major intervention programs. This project is the direct extension of our previously funded work investigating the role of patient activation in predicting post-operative health behavior. Having a valid and reliable tool to identify individuals with low patient activation and, therefore, at risk for poor recovery speaks to the need for an intervention strategy. The current proposal seeks to investigate the impact of a brief Health Behavior Change Counseling (HBCC) on patient activation and post-operative health behavior and functional recovery. We plan to enroll two consecutive cohorts of individuals undergoing elective surgery for degenerative disease of the lumbar spine. The first cohort will undergo standard preoperative care. The second cohort will undergo standard pre-operative care with an additional brief HBBC intervention session (a patient-centered directive method for eliciting motivation to change behavior). Both groups will be following for 24 months post-operatively.

描述（由申请人提供）：脊柱手术是美国最常见和最昂贵的住院手术之一，其发病率在过去二十年中急剧增加，特别是在 60 岁以上或患有脊柱退行性疾病的患者中。脊柱手术后的恢复情况变化很大，无法用传统研究因素来解释。美国医学研究所（IOM）向美国医疗保健系统发出挑战，要求改善以患者为中心的医疗保健。这一挑战源于以下事实：以患者为中心的护理对医疗保健的规划、提供和评估方式产生了深远的影响。最近的证据支持这样的假设：以患者为中心的干预措施通过赋予患者个体权力来改善结果。这种授权可以通过提高自我效能和患者积极性来实现。这种方法是几个主要干预计划的核心原则。该项目是我们之前资助的研究患者激活在预测术后健康行为中的作用的工作的直接延伸。拥有有效且可靠的工具来识别患者激活度较低且因此面临恢复不良风险的个体，说明需要采取干预策略。目前的提案旨在调查简短的健康行为改变咨询 (HBCC) 对患者激活以及术后健康行为和功能恢复的影响。我们计划连续招募两组接受腰椎退行性疾病择期手术的患者。第一批将接受标准的术前护理。第二组将接受标准的术前护理，并进行额外的简短 HBBC 干预课程（一种以患者为中心的指导方法，用于激发改变行为的动机）。两组患者均将在术后进行 24 个月的随访。