Optimizing Chronic Illness Self-Management for Individuals with Schizophrenia

描述（由申请人提供）：摘要恢复被引用在美国精神卫生保健转型，联邦行动议程：第一步，作为“单一的最重要的目标”的精神卫生服务提供系统。身体健康越来越被认为是更全面的恢复方法的关键组成部分。精神分裂症患者的医疗共病率升高，是一个重大的公共卫生挑战，具有深远的服务提供，成本和质量的影响。为了更有效地解决这一问题，迫切需要创新和便携式干预措施。尽管越来越多的认识到，自我管理策略持有巨大的承诺，提高质量和结果的照顾慢性医学疾病，自我管理的事实越来越突出的恢复为导向的治疗重点，相对较少的是知道如何扩展使用有效的医疗自我保健计划，以帮助精神分裂症患者更积极地参与他们的健康和医疗保健管理。为了解决这一差距，我们的R34申请符合PAR-06-248“从干预开发到服务：探索性研究赠款（R34）”的目标，并建议开发和试点测试现有有效的慢性疾病自我管理计划的优化版本，以更好地满足精神分裂症成年人的需求。我们的具体目标是：1.为拟议的适应性慢性医学疾病自我管理干预制定干预材料和手册。2.根据6-8名患者的初步短期试验，完善材料和实施程序。3.对50名参与者实施一项仔细监测的试点试验，并在6个月时测量对以下主要结果的影响：a）与健康相关的自我效能和康复取向; B）医疗疾病自我管理技能; c）侧重于与卫生保健提供者互动的社交/沟通技能; d）身心健康状况;以及f）医疗服务使用模式。二次探索性分析将检查各种协变量对干预有效性的修正效应，包括药物使用、神经认知、物质滥用、精神症状、相关合并症的数量和严重性以及消费者参与干预的定量和定性评级。该R34申请符合PAR-06-248“从干预开发到服务：探索性研究赠款（R34）”的目标，并建议开发和试点测试现有有效的慢性医学疾病自我管理计划的优化版本，以更好地满足精神分裂症成年人的需求。

DESCRIPTION (provided by applicant): Abstract Recovery is cited within Transforming Mental Health Care in America, Federal Action Agenda: First Steps, as the "single most important goal" for the mental health service delivery system. Increasingly, physical wellness is being recognized as a key component of a more holistic approach to recovery. The elevated rates of medical co-morbidity among individuals with schizophrenia represent a significant public health challenge with profound service delivery, cost and quality implications. Innovative and portable interventions are sorely needed to more effectively address this problem. Despite the growing recognition that self-management strategies hold enormous promise for improving quality and outcomes of care for chronic medical illnesses, and the fact that self-management is gaining prominence as a recovery oriented treatment focus, relatively little is known about how to extend use of effective medical self-care programs to help persons with schizophrenia more actively participate in their health and medical care management. To address this gap, our R34 application meets the objectives of PAR-06-248 "From Intervention Development to Services: Exploratory Research Grants (R34)" and proposes to develop and pilot test an optimized version of an existing and effective chronic medical illness self-management program to better meet the needs adults with schizophrenia. Our specific aims are to: 1. Develop intervention materials and a manual for the proposed adapted chronic medical illness self management intervention. 2. Refine materials and implementation procedures based on a preliminary, short-term trial with 6-8 patients. 3. Implement a carefully monitored pilot trial for 50 participants and measure the effect at 6 months on the primary outcomes of: a) health related self-efficacy and recovery orientation; b) medical illness self-management skills; c) social/communication skills focusing on interactions with health care providers; d) physical and mental health status; and f) medical service use patterns. Secondary, exploratory analyses will examine the modifying effect of various covariates on the effectiveness of the intervention including medication use, neurocognition, substance abuse, psychiatric symptoms, number of and seriousness of related comorbidities, and quantitative and qualitative ratings of consumer participation in the intervention. This R34 application meets the objectives of PAR-06-248 "From Intervention Development to Services: Exploratory Research Grants (R34)" and proposes to develop and pilot test an optimized version of an existing and effective chronic medical illness self-management program to better meet the needs adults with schizophrenia.