Psychological Well Being and Recovery Among Older Hospitalized Adults

描述（由申请人提供）：我们提议的研究涉及题为“身心相互作用与健康研究”的项目公告（PA-07-046）。具体来说，我们解决了国家老龄化研究所（NIA）在探索急性疾病住院的老年人心理健康和功能能力之间关系的兴趣。建议申请的具体目的是：1。检查住院期间和出院后一年内功能状态的变化。在5个时间点（入院和出院24小时内，出院后1个月、6个月和12个月），通过一系列措施（4米步行、握力测试、膝关节伸肌强度测试和7项日常生活活动（adl））评估功能状态。2. 检查住院期间和出院后长达一年的心理健康和功能状态之间的直接和间接联系。心理健康，通过六域心理健康工具和积极影响总结量表进行评估，将用于检查在目标1中概述的5个时间点上与功能状态的关联模式。3. 检查心理健康是否改变了与住院期间和出院后一年内功能状态相关的种族健康差异。这一目标将使我们能够研究种族群体（非西班牙裔白人、非西班牙裔黑人和西班牙裔）如何与心理健康相互作用，从而影响目标1中概述的5个时间点的功能状态。为了探索我们的目标，我们计划对800名不同种族的老年患者（非西班牙裔白人、非西班牙裔黑人和西班牙裔）进行随访，这些患者住在德克萨斯大学医学分部的老年人急性护理（ACE）病房。参加研究的老年人将在五个时间点进行评估：入院24小时内，出院24小时内以及出院后1、6和12个月。这五个时间点将使我们不仅能够检查功能状态和心理健康之间影响的总体模式，而且还将使我们能够检查不同时间段的影响模式，包括住院和出院后。三次出院后随访访谈将进一步允许我们检查和解释功能状态和心理健康之间的关系，这些关系与短期（1个月）和长期（6个月和12个月）康复模式有关。当前应用程序的一个中心目标是检查心理健康是否可以影响与住院治疗相关的功能状态下降的风险在不同种族的老年患者人群中。

DESCRIPTION (provided by applicant): Our proposed study addresses the Program Announcement entitled "Research on Mind-Body Interactions and Health" (PA-07-046). Specifically, we address the National Institute on Aging (NIA) interest in exploring associations between psychological well-being and functional ability in older adults hospitalized for acute illness. The Specific Aims of the proposed application are to: 1. Examine change in functional status during hospitalization and up to one-year post hospital discharge. Functional status will be assessed by a battery of measures (a 4 meter walk, a test of grip strength, knee extensor strength and seven activities of daily living (ADLs)) at 5 time points: within 24 hours of hospital admission and discharge, and 1, 6 and 12 months post discharge. 2. Examine direct and indirect associations between psychological well-being and functional status during hospitalization and up to one-year post hospital discharge. Psychological well-being, assessed by a 6- domain psychological well-being instrument and a positive affect summary scale, will be used to examine patterns of association with functional status over the 5 time points outlined in aim 1. 3. Examine whether psychological well-being modifies ethnic health disparities associated with functional status during hospitalization and up to one-year post hospital discharge. This aim will allow us to examine how ethnic group (non-Hispanic whites, non-Hispanic blacks and Hispanics) interacts with psychological well-being to influence functional status over the 5 time points outlined in aim 1. To explore our aims, we plan to follow up an ethnically diverse sample of 800 older patients (non-Hispanic whites, non-Hispanic blacks and Hispanics) admitted to the Acute Care for Elders (ACE) unit at the University of Texas Medical Branch. Older adults enrolled in the study will be assessed at five time points: within 24 hours of hospital admission, within 24 hours of hospital discharge and 1, 6 and 12 months post discharge. The five time points will allow us not only to examine overall patterns of effect between functional status and psychological well-being but it will also allow us to examine patterns of effect over distinct time periods including hospitalization and post discharge. The three post discharge follow up interviews will further allow us to examine and explain associations between functional status and psychological well-being in relation to short (1 month) and longer term (6 and 12 month) recovery patterns. A central goal of the current application is to examine whether psychological well-being can influence the risk for functional status decline associated with hospitalization in an ethnically diverse older patient population.