Nursing Management of IBS: Improving Outcomes

描述：(申请者提供)建议的研究是一项竞争性研究 NINR资助的研究者题为“肠易激综合征的护理研究： 目前的研究直接建立在研究人员的 个体化综合非药物干预的研究 自我管理以减少胃肠道症状和提高妇女的生活质量 (20-45岁)患有肠易激综合征。在这项研究中，患有IBS妇女接受了 全面的自我管理计划显著减少了GI 症状、心理困扰和生活质量的改善 妇女在常规护理和简明教育干预组。尽管 与干预相关的积极结果，结果可能不是 适用于围绝经期和绝经后年龄的男性或女性。 拟议研究的目的是：1)测试 面对面的个性化综合自我管理计划和 相对于男性和普通护理组的电话版本的器械 患有肠易激综合征的女性。结果指标将是胃肠道症状、睡眠障碍、 心理困扰、疾病影响与健康相关的生活质量 (HRQOL)和2)探讨胃肠道症状改善与年龄的关系 通过预期的报告衡量的心理痛苦的减少 焦虑和抑郁，以及全球心理回顾报告 苦恼与生理唤醒下降的关系探讨 根据基础儿茶酚胺水平和基础皮质醇水平来衡量 还有女人。一项纵向随访的三组随机临床试验 将用于测试面对面(n=60)与电话的有效性 综合自我管理计划(n=60)，相对于常规护理控制 对照组(n=60)。将在基线评估期间对成果衡量标准进行衡量 阶段，以及随机化后的3、6和12个月。这项研究是 重要的是，与IBS患者合作的医疗保健提供者 挑战在于根本的病理没有被很好地定义，而且有 可用的药物治疗有限。到目前为止，非药物干预 试验一直受限于样本量小，缺乏对性别的关注 具体问题，只有少数几个包括长期后续行动。

DESCRIPTION: (provided by applicant) The proposed study is a competitive renewal of the investigators' NINR funded study entitled "nursing Study of IBS: Improving Outcomes." The current study builds directly on the investigator's study of a non-pharmacologic intervention entitled individualized comprehensive self-management to reduce GI symptoms and enhance quality of life in women (ages 20-45) with IBS. In that study women with IBS who received a comprehensive self-management program had significant reductions in GI symptoms, psychological distress, and improved quality of life compared to women in the usual care and brief educational intervention groups. Despite the positive outcomes associated with the intervention, the results may not be generalizable to men or to women of peri-menopausal and post-menopausal age. The aims of the proposed study are to 1) test the effectiveness of the face-to-face individualized comprehensive self-management program and a telephone version of the instrument relative to a usual care group in men and women with IBS. Outcome measures will be GI symptoms, sleep disturbance, psychological distress, sickness impact, and health related quality of life (HRQOL) and 2) explore the relationship between GI symptom improvement and a decrease in psychological distress as measured by prospective reports of anxiety and depression, and retrospective reports of global psychological distress and explore the relationship between decrease in physiological arousal as measured by basal catecholamine levels and basal cortisol levels in both men and women. A three group randomized clinical trial with longitudinal follow-up will be used to test the effectiveness of face to face (n=60) versus telephone comprehensive self-management program (n=60), relative to a usual care control group (n=60). Outcome measures will be measured during the baseline assessment phase, and at 3, 6, and 12 months following randomization. This study is important because health care providers working with patients with IBS are challenged in that the underlying pathology is not well defined and there are limited drug treatments available. To date, non-pharmacological intervention trials have been limited by small sample size, lack of attention to gender specific issues, and only a few included long-term follow-ups.