EFFECTS OF STRESSFUL LIFE EVENTS ON HEALTH OUTCOMES

本研究针对两个主要问题：（1）生活应该如何 对事件进行评分和汇总，以实现跨年龄组的最佳有效性？ （2）压力性生活事件在多大程度上影响了 长期患病的老年男女 这项研究的数据来自医学结果研究（MOS），一个大型的 对不同保健制度下的病人进行全国性研究。 两个- 压力性生活事件对健康影响的逐步研究法 将引导分析。 首先，使用所有年龄段患者的数据， 纵向基线样本，若干汇总项目评分方案 和衡量事件的影响进行比较。 这种比较将 帮助确定哪些事件或事件集在 疾病的病因，以及哪种测量方法具有最佳的功效， 检测老年患者亚组中随时间推移的健康状况的微小变化。 在建立了一个合适的算法来操作压力生活之后， 在第一步中，将开发一个模型来确定 随着时间的推移，压力和健康结果之间的关系。 该分析 将在55岁及以上的患者亚组中进行。 该模型将 控制个体特征、疾病严重程度、合并症， 健康状况，并将检查心理和身体健康的变化 在不同的时间间隔（例如，6、12、18和24个月） 压力的发生。 这些发现将为压力的研究做出重要贡献， 改进计量，并通过增加对 压力影响健康的情况下，最终减少其 冲击 这些信息将对医疗保健计划产生影响， 特别是有关为联合国系统 老年人的需求越来越大。

This research is directed toward two main questions: (1) How should life events be scored and aggregated for optimal validity across age groups? and (2) To what extent do stressful life events affect the health of chronically ill, elderly men and women over time? Data for this research are from the Medical Outcomes Study (MOS), a large national study of patients under different systems of health care. A two- step approach for studying the effects of stressful life events on health will guide analyses. First, using data for patients of all ages in the longitudinal baseline sample, several scoring schemes for aggregating items and measuring the impact of events will be compared. This comparison will help determine which events or set of events are most important in the etiology of illness and which method of measurement has the best power to detect small changes in health over time in a subset of older patients. After establishing a suitable algorithm for operationalizing stressful life events in step one, a model will be developed to determine the relationships between stress and health outcomes over time. This analysis will be performed on a subset of patients age 55 and older. The model will control for individual characteristics, severity of illness, comorbidity, health at baseline, and will examine changes in mental and physical health at varying intervals of time (e.g., 6, 12, 18, and 24 months) since the occurrence of stress. Findings will make an important contribution to the study of stress through improvements in measurement and through increasing knowledge about the circumstances under which stress affects health, ultimately reducing its impact. This information will have implications for healthcare planning, particularly those related to the allocation of resources for the increasing needs of the elderly.