Risk of Adverse Outcomes after SCI: A Longitudinal Study

SCI 后不良后果的风险：一项纵向研究

• 批准号: 7030188
• 负责人: JAMES S KRAUSE
• 金额: $ 39.03万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-01 至 2010-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7030188
• 关键词: behavior prediction; behavioral /social science research tag; clinical research; disease /disorder proneness /risk; human subject; longitudinal human study; mathematical model; medical complication; outcomes research; patient oriented research; quality of life; questionnaires; spinal cord injury

DESCRIPTION (provided by applicant): Spinal cord injury (SCI) heightens risk for adverse health outcomes and secondary conditions, including poor general health, the development of chronic health conditions such as pain and fatigue, and poor Dsychosocial adaptation including an elevated risk for depression. Although there are substantial individual differences in likelihood of developing these conditions, the risk factors that account for the variations are not fully understood, nor have they been systematically investigated. The purpose of the proposed 10-year longitudinal study is to identify differential risk for 3 sets of adverse health outcomes using two empirical models to guide selection of risk variables. The first general risk model highlights conceptual categories of risk variables from multiple levels including behavioral, psycho-social/environmental, and biographic/injury factors in predicting morbidity and mortality. The second bi-dimensional behavioral model assesses the risk of poor health outcomes along independent risk and protective behavioral dimensions. Preliminary data was collected 10 years prior to collection of the proposed follow-up outcome data from 1,391 adult participants with traumatic SCI of at least 1-year duration. These participants will complete a self-report battery of measures as will a new sample of over 1,000 cases. Measures will include reassessment of risk factors and a detailed assessment of health outcomes. General linear model will be used to explore the cross-sectional data as a prelude to confirmatory analyses of the longitudinal data using structural equation modeling (SEM). The SEM will include confirmatory factor analysis to test the clarity of our conceptual categories and independence of our outcome measures, longitudinal change modeling to test the direct effects of time 1 predictors on time 2 outcomes, multiple groups modeling to evaluate hypotheses from our bi-dimensional model, and incomplete data modeling to identify and compensate for selective attrition. Results of the study will enhance our understanding of the natural course of health decline and development of secondary conditions, lead to refined predictive models, and will serve as a basis for developing prevention strategies to limit and/or prevent these conditions among people with SCI.

描述（由申请人提供）：脊髓损伤（SCI）增加了不良健康结果和次要状况的风险，包括一般健康状况不佳，慢性健康状况（如疼痛和疲劳）的发展以及不良的心理社会适应性，包括抑郁症的风险升高。尽管开发这些疾病的可能性存在很大的个体差异，但解释差异的风险因素尚未完全了解，也没有系统地研究它们。拟议的10年纵向研究的目的是使用两个经验模型来指导选择风险变量的选择，以确定3组不良健康结果的差异风险。第一个一般风险模型强调了来自多个级别的风险变量的概念类别，包括行为，心理社会/环境以及预测发病率和死亡率的传记/伤害因素。第二个双维行为模型评估了独立风险和保护性行为方面的健康状况不佳的风险。在收集了1,391名成年参与者的拟议后续结果数据之前10年收集了初步数据，其创伤性SCI至少为1年。这些参与者将完成自我报告的措施，以及新样本的1,000多个案例。措施将包括对风险因素的重新评估以及对健康结果的详细评估。通用线性模型将用于探索横截面数据，作为使用结构方程建模（SEM）对纵向数据进行确认性分析的前奏。 SEM将包括确认性因素分析，以测试我们的概念类别的清晰度和结果度量的独立性，纵向变化模型，以测试时间1预测因子对时间2结果的直接影响，多个组建模以评估我们的双维模型中的假设，以及确定和补偿选择性消耗的不完整数据模型。这项研究的结果将增强我们对次要条件健康衰落和发展的自然发展过程的理解，导致精致的预测模型，并将作为制定预防策略以限制和/或防止SCI患者中这些条件的基础。