OLDER PATIENTS PERSONAL MODELS OF CHRONIC DISEASE

该项目将调查两种慢性病的个人模型 老年人、非胰岛素依赖型糖尿病和骨关节炎。 建立在社会认知图式概念的基础上，个人模型 被定义为患者的认知和有效表征 疾病的原因、症状、病程、治疗和后果。 我们的个人模特方法的具体目标是将 个人模型的内容和结构以(A)模型引导的处理 与疾病有关的信息；(B)疾病管理活动和 功能状态。研究两种疾病的个人模型将允许 (个人模型方法在预测中的交叉验证 慢性病的结果变量，以及(B)比较 这两种老年流行疾病的模型。 对每种疾病的单独调查将在一个 连锁研究的顺序。每项调查的对象将是 65岁及以上。对于每种疾病，在第一阶段，我们将制定一种 结构化面谈将提供多个指标，从中可以 构建理论指导的复合变量来评估关键 个人模特的维度。在这些变量上的分数将相关 以适应各种患者的特点。第二阶段将复制第一阶段 使用精制的仪器和不同的样品。此外，我们还将使用 社会认知研究中的几个程序 个性化模型的内容与加工的关系 与疾病相关的信息。最后，在第三阶段，前瞻性研究 将决定个人模型的稳定性及其在 预测疾病管理活动和功能状态。 该项目的长期目标是：(1)促进基本 社会认知理论：通过研究老年人对一种行为的表征 日常生活的重要方面，以及(2)加强 患者教育计划与患者从业者的有效性 旨在提高疾病管理活动水平的互动 和功能状态。

This project will investigate personal models of two chronic diseases in older adults, non-insulin dependent diabetes mellitus and osteoarthritis. Building on the concept of a schema in social cognition, personal models are defined as patients' cognitive and effective representations of the cause, symptoms, course, treatment, and consequences of their illness. The specific aims of our personal-models approach are to relate the content and structure of personal models to (a) model-guided processing of illness-related information, and (b) disease-management activities and functional status. Studying personal models of two diseases will permit (cross-validation of the personal-models approach in the prediction of outcome variables in chronic disease, and (b) comparisons between the models of these two prevalent diseases of old age. Separate investigations of each disease will be conducted in parallel in a sequence of interlocking studies. Subjects in each investigation will be aged 65 and older. For each disease, in Phase 1, we will develop a structured interview that will provide multiple indicators from which to construct theoretically guided composite variables to assess key dimensions of personal models. Scores on these variables will be related to a variety of patient characteristics. Phase 2 will replicate Phase 1 using refined instruments and different samples. In addition, we will use several procedures from research in social cognition to investigate the relations between the content of personal models and the processing of illness-related information. Finally, in Phase 3, prospective studies will determine the stability of personal models and their utility for predicting disease-management activities and functional status. The long-term objectives of this project are to (1) contribute to basic theory in social cognition by studying older adults' representations of an important aspect of their everyday lives, and (2) to enhance the effectiveness of patient-education programs and patient-practitioner interactions designed to increase levels of disease-management activities and functional status.