Older Mothers and Adult Daughters: High Blood Pressure Self Management Behaviors

描述（由申请人提供）：心脏病是美国妇女死亡的主要原因。肯塔基州是美国女性心脏病发病率最高的6个州。这项研究方案将通过协助妇女发展自我管理行为，以减少和控制高血压这一心脏病的主要危险因素，推动2010年健康人倡议。本研究计划的长期目标是确定内在力量、感知控制和年长母亲与其成年女儿的关系质量之间的因果关系，以便制定护理干预措施，以改善心血管自我管理行为和健康相关的生活质量。这项纵向预测研究的具体目的是确定内在力量，感知控制，和老年母亲和他们的成年女儿的血压自我管理行为和健康相关的生活质量的关系质量的影响。为了实现这些目标，候选人设计了一个全面的培训计划，与经验丰富的护士研究人员谁将促进候选人的专业知识在慢性疾病管理的理论观点的发展，特别是血压自我管理，和健康相关的生活质量。候选人将完成正式的课程，并计划与导师和顾问的互动和会议。此外，候选人将参加正在进行的研究研讨会，编写和提交科学出版物，并出席科学会议。导师将博士黛布拉莫泽，教授，美国。美国肯塔基州大学教授内维尔·斯特朗普夫博士宾夕法尼亚州。建议的培训和研究环境是：护理学院和桑德斯布朗中心在美国的老龄化。美国肯塔基州，列克星敦，肯塔基州;宾夕法尼亚州，费城，宾夕法尼亚州;路易斯维尔护理学院，路易斯维尔，肯塔基州。候选人将应用从培训计划中获得的知识来开发一个旨在提高老年高血压女性血压自我管理行为的研究计划。本研究的目的是：（1）使用二元分析来检查直接（即，“演员”）和间接（即，在基线和6个月后测量母亲和女儿的血压和健康相关生活质量的自我管理策略的结果时，母亲和女儿的内在力量的影响，并确定结果是否随时间发生显著变化;（2）采用二元分析方法，探讨控制感是否在母女内在力量与结果之间起中介作用;（3）采用二元分析方法，探讨母女关系是否在母女内在力量与结果之间起中介作用;（4）采用二元分析方法，探讨母女关系质量与控制感之间是否存在显著关系。本研究结果将用于支持一项以理论为基础的护理干预研究计划，旨在提高老年妇女被诊断为高血压时母女二人的血压自我管理行为。成年女儿可能会或可能不会被诊断为高血压，这项研究旨在比较女儿是否被诊断为高血压的关系。候选人以前的工作表明，内在力量是老年妇女及其成年女儿管理健康危机的一个关键概念。候选人计划进一步研究高血压老年妇女内在力量和可改变的健康行为的重要性。

DESCRIPTION (provided by applicant): Heart disease is the leading cause of death in American women. Kentucky ranks as the 6 highest state in the nation for heart disease among women. This program of research will advance the initiatives of Healthy People 2010 by assisting women to develop self management behaviors to reduce and moderate hypertension, a major risk factor for heart disease. The long-term aim of this program of research is to determine the causal relationships of inner strength, perceived control, and quality of the relationship of older mothers and their adult daughters so that nursing interventions can be developed to improve cardiovascular self management behaviors and health related quality of life. The specific aim of this longitudinal predictive study is to determine the impact of inner strength, perceived control, and the quality of the relationship of older mothers and their adult daughters on blood pressure self management behaviors and health related quality of life. To achieve these goals, the candidate has designed a comprehensive training program with experienced nurse researchers who will facilitate the development of the candidate's expertise in the theoretical perspectives of chronic illness management, specifically blood pressure self management, and health related quality of life. The candidate will complete formal coursework and planned interactions and meetings with mentors and consultants. In addition, the candidate will participate in on-going research seminars, prepare and submit scientific publications, and present at scientific sessions. Mentors will be Dr. Debra Moser, Professor, U. of Kentucky and Dr. Neville Strumpf, Professor, U. of Pennsylvania. The proposed training and research environments are: the College of Nursing and Sanders Brown Center on Aging at the U. of Kentucky, Lexington, Kentucky; Hartford Center for Geriatric Nursing Excellence: U. of Pennsylvania, Philadelphia, Pennsylvania; and U. of Louisville School of Nursing, Louisville, Kentucky. The candidate will apply the knowledge gained from the training program to develop a program of research designed to enhance blood pressure self management behaviors of older women with hypertension. The aims of the proposed study are to: (1) Use dyadic analysis to examine the direct (i.e., 'actor') and indirect (i.e., 'partner') effects of mothers' and daughters' inner strength on the outcomes of self management strategies for blood pressure and health related quality of life in both mothers and daughters measured at baseline and 6 months later, and to determine whether there are significant changes over time in the outcomes; (2) To determine, using dyadic analysis, whether perceived control mediates the relationship between inner strength and outcomes in mothers and daughters; (3) To determine, using dyadic analysis, whether the mother-daughter relationship mediates the relationship between inner strength and outcomes in mothers and daughters; (4) To determine, using dyadic analysis, if there is a significant relationship between perceived control and quality of the mother-daughter relationship. The findings from this study will be used to support a program of theory-based nursing intervention studies designed to increase blood pressure self management behaviors of mother-daughter dyads when the older woman is diagnosed with hypertension. The adult daughter may or may not be diagnosed with hypertension and the study is designed to compare relationships whether or not daughters are diagnosed with hypertension. Previous work by the candidate demonstrated that inner strength was a key concept for older women and their adult daughters in managing health crisis. The candidate plans to further examine the significance of inner strength and modifiable health behaviors of older women with hypertension.