Measuring Health-Related Quality of Life in Older Adults with Chronic Illness

描述(由申请人提供)：本申请是针对Not-OD-09-058号通知提交的，标题为“NIH宣布恢复法案资金可用于竞争性修订申请。作为补充，我们建议在我们的R21研究中增加三种激素测量(皮质醇、孕酮和脱氢表雄酮)，题为”患有慢性病的老年人的结局测量“。目前对患有慢性疼痛的老年人的纵向研究涉及一系列广泛的生活质量测量技术。我们建议研究这些荷尔蒙的昼夜模式，这些模式表明调节压力的方式或多或少具有适应性(例如，“挑战”模式与“威胁”模式)。我们将“在体内”收集荷尔蒙数据，这意味着他们会在家里做，同时我们从他们那里获得生态瞬时评估(EMA)数据(事实上，我们将使用我们现有的EMA设备来提示他们保存荷尔蒙样本)。这意味着我们将能够将昼夜荷尔蒙模式与EMA和白天重建法测量身体症状、日常活动和幸福感联系起来。最初的研究设计要求对100名骨关节炎患者和50名健康对照进行两波数据收集。我们已经招募了大部分样本，第二波数据收集将于2009年10月开始。我们建议将荷尔蒙测量添加到第二波数据收集中；我们将在1月底之前收集所有数据--包括新的荷尔蒙测量--从而使我们能够将资助期的最后几个月用于数据分析。 公共卫生相关性：我们的目标是应用情绪测量的方法学进步来改善与健康相关的生活质量测量。具体地说，我们建议考察心理学家为克服回忆偏差而设计的两种较新的测量方法：生态瞬间评估(EMA)，这是一种“实时”测量，因此不受回忆偏差的影响；以及一种基于日记的新生活质量测量方法，即日子重构法(DRM)。我们打算开始在下肢骨关节炎患者(LE-OA)和健康老年人的对照组中测试这些措施的有效性和有效性。

DESCRIPTION (provided by applicant): This application is being submitted in response to Notice Number NOT-OD-09-058, entitled "NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications. For the supplement, we propose to add three hormonal measurements (cortisol, progesterone, and DHEA) to our R21 study entitled "Outcome Measurement in Older Adults with Chronic illness. The current longitudinal study of older adults with chronic pain involves an extensive array of quality of life measurement techniques. We propose to examine diurnal patterns in these hormones that are indicative of more or less adaptive ways of regulating stress (e.g., a "challenge" vs. "threat" pattern). We will collect the hormone data "in vivo," meaning that they would do them at home, at the same time we are getting Ecological Momentary Assessment (EMA) data from them (in fact, we will use our existing EMA device to prompt them to save hormone samples). This means we would be able to relate diurnal hormone patterns to both EMA and Day Reconstruction Method measures of physical symptoms, daily activities, and well being. The original study design called for two waves of data collection on a sample of 100 osteoarthritis patients and 50 healthy controls. We have recruited most of the sample, and wave 2 data collection is due to begin in October, 2009. We propose to add the hormone measurement to the wave 2 data collection; we would have all of the data-including the new hormone measures--collected by the end of January, allowing us to spend the final months of the grant period on data analyses. PUBLIC HEALTH RELEVANCE: Our goal is to apply methodological advances in emotion measurement to improve health-related quality of life measures. Specifically, we propose to examine two newer approaches to measurement that have been designed by psychologists for the purpose of overcoming recall biases: Ecological Momentary Assessment (EMA), which are "real time" measures and therefore not subject to recall biases, and a new diary-based approach to measuring quality of life, the Day Reconstruction Method (DRM). We intend to begin to test the usefulness and validity of these measures among lower extremity osteoarthritis patients (LE-OA) and in a comparison group of healthy older adults.