DEALING WITH RHEUMATOID ARTHRITIS--STRESS, COPING, AND OUTCOMES

治疗类风湿性关节炎——压力、应对方法和结果

• 批准号: 5206141
• 负责人: Patricia P Katz
• 金额: --
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/5206141
• 关键词: age difference; antiarthritic agent; chronic disease /disorder; coping; drug adverse effect; fatigue; functional ability; gender difference; health behavior; health care service utilization; human subject; interview; longitudinal human study; pain; patient care management; physiologic stressor; prognosis; quality of life; questionnaires; rheumatoid arthritis; self care; social psychology; statistics /biometry; stress management

Although individuals may seeks and receive medical treatment for RA, medical treatment cannot always prevent or alleviate the effects of the disease. In addition, there are aspects of the disease that are managed by the individual without medical intervention. The result is that RA has the potential to present serious challenges, or stresses, for the individual. The overarching aims of this project are to determine how people with RA deal with the stresses of the disease, and how disease management and self-care behaviors are associated with outcomes. The proposed research will address these issues using a modification of the Folkman and Lazarus model of stress, appraisal, and coping. Simply described, the model postulates that, following the introduction of an RA stressor, and individual makes certain judgement and resources, and produce coping or adaptive responses to the RA stressor, which then influence both specific outcomes (i.e., activity losses or modifications) as well as more general outcomes such as function, psychosocial well- being, and health service utilization. This project will focus on seven stressors that may be associated with RA or its treatment: pain, fatigue, changes in physical appearance, unpredictability of symptoms, chronicity of the disease and its treatment, side effects of medications, and functional impairment. We will examine the degree to which persons with RA perceive each of these potential stressors as problems, the impact of the stressors, what individuals do to manage or cope with the stressors, and how effective they feel their coping efforts are. Taking this information one step farther, we will also examine how these management, coping, and self-care behaviors are from the RA Panel Study. 628 persons remain in the panel, and approximately 250 persons with newly diagnosed R will be added during the first year of this cycle. All of these individuals will be followed over the five-year study period. Establishment of the relationship of management and coping responses to outcomes is essential if effective responses are to be identified. The results of this study should provide a better understanding of how individuals' multifaceted responses to RA influence health, psychosocial, and health service utilization outcomes. More comprehensive knowledge of the perceptions of these stressors and effective management and coping responses can then be incorporated into patient education programs and into clinical contacts with persons with RA by health professionals, with the goal of improving individuals' ability to deal with RA, thereby improving their quality of life.

尽管个人可能会寻求RA的医疗，但 医疗不能总是防止或减轻 疾病。 此外，疾病的某些方面是由 由没有医疗干预的个人。 结果是RA 有可能提出严重的挑战或压力 个人。 该项目的总体目的是确定 患有RA的人应对疾病的压力，以及疾病如何 管理和自我保健行为与结果有关。 这 拟议的研究将通过修改来解决这些问题 民俗和拉撒路压力，评估和应对模型。 简单地 描述的是，该模型假设在引入 RA压力源，个人做出一定的判断和资源，并且 对RA应激源产生应对或适应性反应，然后 影响特定结果（即活动损失或修改） 以及更一般的结果，例如功能，社会心理良好 存在和健康服务利用。 该项目将集中于可能与之相关的七个压力源 RA或其治疗方法：疼痛，疲劳，外观变化， 症状的不可预测性，疾病的长期性及其 治疗，药物的副作用和功能障碍。 我们 将检查有RA的人认为每个人的程度 潜在的压力源是问题，压力源的影响，什么 个人可以管理或应对压力源，以及 他们认为他们的应对努力是。 遵守此信息一步 更远的是，我们还将研究这些管理，应对和自我保健 行为来自RA小组研究。 有628人留在面板中， 大约250人将在新诊断的R中添加 这个周期的第一年。 所有这些人都将遵循 在五年的研究期间。 建立管理和应对响应的关系 如果要确定有效的响应，结果至关重要。 这 这项研究的结果应该更好地了解 个人对RA的多方面反应会影响健康，社会心理， 和健康服务利用结果。 更全面的知识 这些压力源的看法以及有效的管理和应对 然后，可以将回应纳入患者教育计划中，并 与卫生专业人员与RA的人进行临床接触， 提高个人处理RA的能力的目标，从而 改善他们的生活质量。