The role of partner support in chronic disease outcomes

项目背景在英国，患者护理和疾病管理通常被视为个人关注的问题，而不是认识到疾病管理是一个社会过程。该项目提供了一个令人兴奋的机会，可以开发和测试一个全面的帐户，说明合作伙伴的互动如何影响慢性疾病，并与慢性疾病管理和关节炎患者的护理直接相关。患者报告的结果是治疗炎症性关节炎的重要措施，但它们本质上是主观的，可能受到临床环境中被忽视的社会因素(例如，社会支持)的影响。在炎症性关节炎中，患者和医生对疾病活动的全球评估经常存在很大的不一致，这影响了治疗决策、患者满意度和依从性。过度依赖患者全球评估的生理预测因素意味着可能导致患者-医生不和谐的重要社会信息(例如，与伴侣的互动)被忽视。转向生物-心理-社会模型方法，包括了解社会背景的影响，应该有助于更好的疾病管理。项目目的和目标这个令人兴奋的博士项目旨在研究伴侣之间的日常互动如何影响患者报告的疾病结果，并可能解释患者和医生对炎症性关节炎疾病活动的全球评估之间的差异。具体目标包括：1.综合目前有关关节炎患者伴侣支持和患者报告结果之间关系的证据。检查伴侣互动与患者报告的结果之间的日常关联。3.检查日常伴侣互动和患者报告的疾病结果之间的纵向关联，以及长期的全球评估中患者与医生之间的不一致。4.确定在不同类型的炎症性关节炎中，伴侣如何相互作用、患者-医生评估的异同。尝试可能的心理社会干预措施，以改善患者报告的疾病结局。

Project background In the UK, patient care and disease management are typically treated as individual concerns rather than recognising that disease management is a social process. This project offers an exciting opportunity to develop and test a comprehensive account of how partner interactions impact chronic disease, with immediate relevance to chronic disease management and care of arthritis patients. Patient reported outcomes are important measures in management of inflammatory arthritis, but they are inherently subjective, and may be influenced by social factors overlooked in clinical contexts (e.g., social support). There is often a large discordance between patient and physician global assessments of disease activity in inflammatory arthritis, which impacts treatment decisions, patient satisfaction and compliance. An overreliance on physiological predictors of patient global assessments means that important social information (e.g., interactions with partners) which may contribute to patient-physician discordance have been overlooked. Shifting to a bio-psycho-social model approach which includes understanding the impact of social contexts should contribute to a better disease management.Project aims and objectivesThis exciting PhD project aims to examine how daily interactions between partners influence patient-reported disease outcomes and may account for discrepancies between patient and physician global assessments of disease activity in inflammatory arthritis. Specific objectives include:1. Synthesizing the current evidence regarding associations between partner support and patient reported outcomes among arthritis patients.2. Examining daily associations between partner interactions and patient reported outcomes. 3. Examining longitudinal associations between daily partner interactions and patient reported disease outcomes, and the over-time patient-physician discordance on global assessments. 4. Identifying the similarities and differences in how partner interactions patient-physician assessments across different types of inflammatory arthritis.5. Piloting possible psycho-social interventions to improve patient reported disease outcomes.