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，即个人如何使用宗教/精神来处理慢性疾病等压力源，与成年人的身心结局改善有关，但对患有慢性疾病（如哮喘）的青少年的宗教/精神应对知之甚少。目的：作为一名对精神和应对慢性病青少年感兴趣的临床健康心理学家，该奖项的具体目标是：a）提高我在测量开发和研究方法方面的技能，以有效评估宗教/精神因素与青少年健康结果之间的关系，B）验证2种广泛使用的成人精神测量方法，用于青少年，以及c）发展和试验一种以灵性为基础的干预措施，以评估在患有慢性疾病的青少年中使用的可行性。培训内容：为了我的职业发展，我计划在具体的定性和定量方法，数据分析和手稿/资助准备方面接受进一步的培训。培训活动还将包括课程作业、辅导的二级数据分析和临床工作。我的导师团队由灵性，健康相关的生活质量，青少年医学，慢性病和研究方法领域的领先专家组成：Joel Tsevat，MD，MPH（主要共同赞助商），Susan Rosenthal，博士（共同赞助商），Maria Britto，MD，MPH，Kenneth Pargament，博士和Paul Succop，博士。研究设计/方法：研究计划包括3个项目，共涉及165例青少年哮喘门诊患者。项目1是一项定性研究，25名青少年使用半结构化访谈，以确定：a）是否2广泛使用的成人精神措施是青少年可以理解的，B）的范围和深度的宗教/精神的应对策略，以及c）为什么青少年使用宗教/精神的应对策略。项目2是一项定量前瞻性研究，115名青少年使用问卷调查：a）利用探索性因素分析和其他统计技术评估2项成人灵性测量的心理测量学特性，以及B）检查宗教/灵性，宗教/精神应对和健康结果之间的横截面和纵向关系（即，健康相关的生活质量，抑郁/焦虑），并使用结构方程模型来评估调节变量（例如，发育阶段/年龄）和潜在的介导途径（例如，社会支持）。项目3是一项试点可行性研究，有25名青少年，以检查是否从项目1和2的结果开发的精神为基础的干预是可行的，用于青少年哮喘。研究结果将告知R 01纵向随机对照试验的应用程序，比较基于精神的干预与标准的心理社会干预，以改善慢性病青少年的健康结果。

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.