A Mixed Methods Investigation of Self-Care of Chronic Illness in Community-Dwelling Older Adults with Hearing Loss

项目摘要 此个人国家研究服务奖(NRSA)应用程序的目标是提供 受过研究培训的申请者将成为一名独立调查员，解决残疾健康公平问题 关注听力损失(HL)在保健实践中的作用的老年人听力损失(HL) 比如慢性病的自我护理。为了实现这一目标，培训将在资源丰富的环境中进行， 来自多学科导师团队的支持，该团队在HL、护理、老龄、残疾健康公平、 健康促进、慢性病、生物统计学、混合方法和定性研究。申请人 提出包括课程作业、实践培训、研讨会和持续参与的培训计划 研究。该奖项的具体培训目标包括：1)基本了解 健康公平研究，重点是残疾健康公平，2)继续发展方法学和 进行严格的混合方法所需的分析定性、定量和混合方法技能 研究，3)发展HL、衰老、慢性病科学的理论和概念知识，以及 自我护理，支持实证性调查和干预发展，以及4)获得专业知识 发展技能以支持在研究密集型大学担任独立调查员的职业生涯。 这项为NRSA提出的研究解决了HL在慢性病自我护理中的作用。数以百万计 老年人有临床上有意义的HL和慢性病。自我保健是促进健康的基石 和管理慢性病。然而，HL对慢性病自我护理的影响还不是很清楚。 使用残疾和自我护理的综合生物-心理-社会模式作为指导框架，申请人 将研究HL在慢性病自我护理中的作用。本研究提出以下目标：1)描述 老年非霍奇金淋巴瘤患者的自理行为及与病情严重程度的比较 在无人帮助的情况下照顾慢性病的经验，以及HL对自我护理的影响；3) 用自我护理行为评分和HL描述慢性病患者自我护理体验的差异 严肃性。这项混合方法研究将使用平行-收敛设计来招收单个样本 居住在社区的患有慢性病和无人帮助的HL的老年人住院。这项拟议的研究与 与国家护理研究所的优先事项相一致，通过促进患者的健康公平 通过在患有HL的老年人中促进健康和预防疾病，来解决残疾问题。拥有一个 更好地了解HL如何影响自我护理行为将支持干预措施的发展 使患有HL的老年人能够通过自我护理最大限度地促进健康。

Project Summary The goal of this individual National Research Service Award (NRSA) application is to provide the applicant with research training to become an independent investigator addressing disability health equity for older adults with hearing loss (HL) by focusing on the role of hearing loss (HL) in health maintenance practices such as self-care of chronic illness. To achieve this goal, training will occur in a resource rich environment with support from a multidisciplinary mentorship team with expertise in HL, nursing, aging, disability health equity, health promotion, chronic illness, biostatistics, mixed methods, and qualitative research. The applicant proposes a training plan that includes coursework, practical training, seminars, and engagement in ongoing research. Specific training goals of this award include: 1) Gain a foundational understanding of the principles of health equity research, focusing on disability health equity, 2) Continue developing the methodological and analytical qualitative, quantitative, and mixed methods skills required to conduct rigorous mixed methods research, 3) Develop theoretical and conceptual knowledge in the science of HL, aging, chronic illness, and self-care to support empirical investigation and intervention development, and 4) Acquire professional development skills to support a career as an independent investigator at a research-intensive university. The research proposed for this NRSA addresses the role of HL in self-care of chronic illness. Millions of older adults have clinically meaningful HL and a chronic illness. Self-care is a cornerstone of health promotion and management chronic illness. Yet, the impact of HL on self-care of chronic illness is not well understood. Using an integrated biopsychosocial model of disability and self-care as the guiding framework, the applicant will examine the role of HL in self-care of chronic illness. This study proposes the following aims: 1) Describe self-care behaviors in older adults with unaided HL and compare self-care behaviors by HL severity, 2) Explore the experience of caring for chronic illness while having unaided HL, and how HL impacts self-care, and 3) Describe differences in the experiences of self-care of chronic illness by self-care behavior scores and HL severity. This mixed methods study will use a parallel-convergent design to enroll a single sample of community-dwelling hospitalized older adults with a chronic illness and unaided HL. The proposed study aligns with the priorities of the National Institute of Nursing Research by advancing health equity for people with disabilities, through addressing health promotion and disease prevention in older adults with HL. Having a greater understanding of how HL influences self-care behaviors will support the development of interventions enabling older adults with HL to maximize health through self-care.