Psychological Well Being and Recovery Among Older Hospitalized Adults

描述（由申请人提供）：我们提出的研究解决了题为“身心互动与健康研究”（PA-07-046）的项目公告。具体来说，我们解决了国家老龄化研究所（NIA）的兴趣，探索心理健康和功能能力之间的关联，在老年人住院急性疾病。拟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。将在5个时间点通过一系列测量（4米步行、握力测试、膝伸肌力量和7项日常生活活动（ADL））评估功能状态：入院和出院后24小时内以及出院后1、6和12个月。2.检查住院期间和出院后一年内心理健康和功能状态之间的直接和间接关联。通过6个领域的心理健康工具和积极情感总结量表评估的心理健康将用于检查目标1中概述的5个时间点内与功能状态的关联模式。3.检查心理健康是否会改变住院期间和出院后一年内与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，以影响目标1中概述的5个时间点的功能状态。为了探索我们的目标，我们计划随访800名入住德克萨斯大学医学分支急性老年护理（ACE）部门的老年患者（非西班牙裔白人、非西班牙裔黑人和西班牙裔）的种族多样性样本。入组研究的老年人将在五个时间点进行评估：入院后24小时内，出院后24小时内以及出院后1个月，6个月和12个月。这五个时间点不仅可以让我们检查功能状态和心理健康之间的整体影响模式，还可以让我们检查不同时间段（包括住院和出院后）的影响模式。三个出院后的随访访谈将进一步使我们能够检查和解释功能状态和心理健康之间的关联，与短期（1个月）和长期（6个月和12个月）恢复模式有关。本申请的中心目标是检查心理健康是否可以影响种族多样性老年患者人群中与住院相关的功能状态下降的风险。

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.