Spiritual Coping and Quality of Life in Adolescents with Chronic Illness

描述(申请人提供)：背景：宗教/精神应对，即个人如何利用宗教/精神来应对慢性病等应激源，与成年人的身体和心理结果改善有关，但对患有慢性病(如哮喘)的青少年的宗教/精神应对知之甚少。目的：作为一名对慢性疾病青少年的灵性和应对感兴趣的临床健康心理学家，该奖项的具体目标是：a)提高我在测量发展和研究方法方面的技能，以有效地评估宗教/精神因素与青少年健康结果之间的关系，b)验证两种广泛用于青少年的成人灵性测量方法，以及c)开发和试点测试基于精神的干预措施，以评估在患有慢性病的青少年使用的可行性。培训：为了我的职业发展，我计划接受具体的定性和定量方法、数据分析和稿件/赠款准备方面的进一步培训。培训活动还将包括课程作业、辅助性辅助数据分析和临床工作。我的导师团队由灵性、与健康相关的生活质量、青春期医学、慢性病和研究方法领域的领先专家组成：Joel Tsevat，医学博士，公共卫生硕士(主要共同发起人)，Susan Rosenthal，博士(共同发起人)，Maria Britto，医学博士，公共卫生硕士，Kenneth Pargant博士，博士和Paul Succope博士。研究设计/方法：研究计划由3个项目组成，共涉及165例青少年哮喘患者。项目1是对25名青少年进行的定性研究，采用半结构化访谈，以确定：a)青少年是否可以理解两种广泛使用的成人灵性措施；b)所使用的宗教/精神应对策略的广度和深度；以及c)为什么青少年使用宗教/精神应对策略。项目2是一项对115名青少年使用问卷进行的定量前瞻性研究，目的是：a)利用探索性因素分析和其他统计技术评估两种成人灵性测量的心理测量学特性；b)检查宗教信仰/灵性、宗教/精神应对和健康结果(即与健康相关的生活质量、抑郁/焦虑)之间的横向和纵向关系，并使用结构方程模型评估调节变量(例如，发育阶段/年龄)和潜在的中介途径(例如，社会支持)。项目3是一项对25名青少年进行的试点可行性研究，以检查根据项目1和项目2的调查结果制定的精神干预措施是否适用于患有哮喘的青少年。研究结果将为R01应用纵向随机对照试验提供信息，比较基于精神的干预和标准的心理社会干预，以改善患有慢性病的青少年的健康结果。

DESCRIPTION (provided by applicant): Background: Religious/spiritual coping, that is, how individuals use religion/spirituality to deal with a stressor like a chronic illness, has been associated with improved physical and psychological outcomes in adults, but little is known about religious/spiritual coping in adolescents with a chronic illness, such as asthma. Objectives: As a clinical health psychologist interested in spirituality and coping in adolescents with chronic illness, the specific objectives for this award are to: a) enhance my skills in measurement development and research methodology to assess effectively the relationships between religious/spiritual factors and health outcomes for adolescents, b) validate 2 widely-used adult spirituality measures for use in adolescents, and c) develop and pilot test a spiritually-based intervention to assess feasibility of use in adolescents with a chronic illness. Training: For my career development, I plan to take further training in specific qualitative and quantitative methods, data analysis, and manuscript/grant preparation. Training activities will also include coursework, mentored secondary data analyses, and clinical work. My mentorship team is comprised of leading experts in the fields of spirituality, health-related quality of life, adolescent medicine, chronic illness, and research methodology: Joel Tsevat, MD, MPH (primary co-sponsor), Susan Rosenthal, PhD (co-sponsor), Maria Britto, MD, MPH, Kenneth Pargament, PhD, and Paul Succop, PhD. Research Design/Methods: The research plan consists of 3 projects involving a total of 165 adolescent outpatients with asthma. Project 1 is a qualitative study with 25 adolescents using semi-structured interviews to determine: a) whether 2 widely-used adult spirituality measures are understandable by adolescents, b) the range and depth of religious/spiritual coping strategies used, and c) why adolescents use religious/spiritual coping strategies. Project 2 is a quantitative prospective study with 115 adolescents using questionnaires to: a) assess the psychometric properties of 2 adult spirituality measures utilizing exploratory factor analysis and other statistical techniques, and b) examine the cross-sectional and longitudinal relationships among religiosity/spirituality, religious/spiritual coping, and health outcomes (i.e., health-related quality of life, depression/anxiety), and use structural equation modeling to assess moderating variables (e.g., developmental stage/age) and potential mediating pathways (e.g., social support). Project 3 is a pilot feasibility study with 25 adolescents to examine whether a spiritually-based intervention developed from findings from Projects 1 and 2 is feasible for use in adolescents with asthma. Findings will inform an R01 application of a longitudinal randomized controlled trial comparing a spiritually-based intervention versus a standard psychosocial intervention to improve health outcomes in adolescents with chronic illness.