Symptom Cluster Profiles Following Traumatic Orthopaedic Injuries

骨科创伤后的症状群概况

基本信息

批准号：
10218102
负责人：
Stephen T Breazeale
金额：
$ 3.85万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-01 至 2021-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10218102
关键词：
Activities of Daily Living Address Affect Age Alleles American Amygdaloid structure Anxiety Axon Biological Biological Markers Brain-Derived Neurotrophic Factor Caring Cause of Death Clinical Codon Nucleotides Cross-Sectional Studies Data Development Diabetes Mellitus Etiology Foundations Fracture Healing Future Genes Genotype Growth Health Health Care Costs Health Expenditures Health Status Heart Diseases Hippocampus (Brain)Hour Individual Injury Intervention Knowledge Lead Life Logistic Regressions Malignant Neoplasms Measures Mental Depression Mental Health Methionine Modeling Nature Neuraxis Nursing Research Orthopedics Outcome Pain Persons Physical activity Population Precision Health Production Productivity Proteins Quality of life Recovery Research Risk Role Sampling Self Management Serum Single Nucleotide Polymorphism Sleep disturbances Spinal Cord Strategic Planning Subgroup Survivors Symptoms Testing Time Training Traumatic injury United States National Institutes of Health Up-Regulation Valine Work anxiety symptoms base biobehavior career clinical care comorbidity design enhancing factor experience healing health related quality of life high risk improved individual response neuron development neurotrophic factor pain symptom patient population patient subsets postsynaptic neurons preclinical study prevent recruit screening societal costs stress related disorder symptom cluster symptom management symptom science theories therapy development trauma centers

项目摘要

PROJECT SUMMARY Each year, traumatic injuries affect millions of Americans, resulting in $671 billion in healthcare costs and lost productivity. They are also the leading cause of death before age 47 and of years of potential life lost before age 75. In addition to societal costs, symptoms, such as pain, sleep disturbance, anxiety, depression, and stress related disorders are highly prevalent following traumatic orthopaedic injuries (TOI) and may contribute to negative long-term health outcomes. Identifying symptom cluster profiles following TOI may lead to recognizing those at highest risk for negative outcomes. Although the mechanisms for symptom cluster profiles are not completely known, they may share a common etiology. Using a theoretical framework created by incorporating the National Institutes of Health Symptom Science Model and the Theory of Unpleasant Symptoms, the proposed study will utilize a cross- sectional design to describe membership in symptom cluster profiles, examine the associations between demographic and clinical factors and membership in symptom cluster profiles, and measure the extent to which serum brain-derived neurotrophic factor (BDNF) and the val66met single nucleotide polymorphism (rs6265) of the BDNF gene are associated with membership in symptom cluster profiles among a diverse sample of TOI survivors recruited within the first 24 hours of their injury in a large, urban level one trauma center. Latent profile analysis with multinomial logistic regression will be used to describe group membership in the symptom cluster profiles and their associations with demographic and clinical factors and biomarker data. The aims of this study are to 1) describe TOI survivors' membership in symptom cluster profiles, indicated by pain, sleep disturbance, and symptoms of anxiety, depression, and stress related disorders, immediately following a TOI; and 2) examine associations between demographic and clinical factors and symptom cluster profile membership among TOI survivors. 3) test the hypothesis that low serum concentrations of BDNF are associated with membership among symptom cluster profiles following TOI; and 4) test the hypothesis that the presence of the val66met SNP on one or both alleles of the BDNF gene is associated membership among symptom cluster profiles following TOI. The results of this study will provide essential preliminary data to support future studies examining self- and symptom management following TOI. The training plan includes specific experiences designed to promote extensive knowledge of the biobehavioral responses of individuals following TOI, and the screening and management of post-injury symptoms. Aligned with the NINR's strategic plan to promote precision health through research of the role of biomarkers in symptom science, the proposed work will provide an essential foundation for a career in nursing research focused on investigating biobehavioral mechanisms of, and interventions for, symptom cluster profiles in TOI survivors.

项目概要每年，创伤性伤害都会影响数百万美国人，造成 6,710 亿美元的医疗费用和失去生产力。它们也是 47 岁之前死亡和潜在寿命损失的主要原因 75 岁之前。除了社会成本之外，疼痛、睡眠障碍、焦虑、抑郁等症状，与压力相关的疾病在创伤性骨科损伤 (TOI) 后非常普遍，并且可能导致负面的长期健康结果。识别 TOI 后的症状群概况可能会导致识别出阴性风险最高的人结果。尽管症状群特征的机制尚不完全清楚，但它们可能共享一个常见病因。使用美国国立卫生研究院创建的理论框架症状科学模型和不愉快症状理论，拟议的研究将利用交叉分段设计来描述症状群概况中的成员资格，检查之间的关联人口统计学和临床因素以及症状群概况中的成员资格，并衡量其程度其中血清脑源性神经营养因子（BDNF）和val66met单核苷酸多态性 BDNF 基因的 (rs6265) 与不同症状群的成员资格相关。在大型城市一级创伤中受伤后 24 小时内招募的 TOI 幸存者样本中心。多项逻辑回归的潜在概况分析将用于描述组成员身份症状群概况及其与人口统计、临床因素和生物标志物数据的关联。本研究的目的是 1) 描述 TOI 幸存者在症状群概况中的成员资格，表明如果出现疼痛、睡眠障碍以及焦虑、抑郁和压力相关疾病的症状，请立即关注 TOI； 2）检查人口统计学和临床因素与症状群之间的关联 TOI 幸存者的概况。 3) 检验低血清 BDNF 浓度的假设与 TOI 后的症状群概况中的成员资格相关； 4）检验假设 BDNF 基因的一个或两个等位基因上存在 val66met SNP 与以下成员相关： TOI 后的症状群概况。这项研究的结果将提供重要的初步数据，以支持未来研究自我和 TOI 后的症状管理。培训计划包括旨在促进对 TOI 后个体生物行为反应的广泛了解，以及筛选和受伤后症状的管理。符合 NINR 促进精准健康的战略计划通过研究生物标志物在症状科学中的作用，拟议的工作将为护理研究职业的基础，重点研究生物行为机制，和针对 TOI 幸存者症状群概况的干预措施。