SELF-MANAGEMENT OF SICKLE CELL DISEASE

镰状细胞病的自我管理

• 批准号: 7019686
• 负责人: Stephen Ryan McCauley
• 金额: $ 18.75万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-02-15 至 2008-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7019686
• 关键词: attention; behavioral /social science research tag; central nervous system disorders; child behavior; clinical research; functional ability; health care model; human subject; memory; middle childhood (6-11); model design /development; neuropsychology; patient care management; patient oriented research; pediatrics; questionnaires; self care; sickle cell anemia

DESCRIPTION (provided by applicant): Project Summary: The main goal of this 2-year pilot project (in response to PA 03-159) is to apply the Children's Health Belief Model (CHBM) to predict self-management behaviors in children age 6-13 years of age with sickle cell disease (SCO). As these children grow older, they become increasingly more responsible for the management of their disease. This may involve both preventative actions and medications. Models to predict medical self-management and adherence outcome in children have largely focused on specific environmental and psychosocial factors (such as motivation, perceived threat, risk-taking behavior, socioeconomic status, etc.), but have not used a more complete modeling of these factors in combination to specifically address children with chronic medical illness, including SCO Furthermore, no models thus far have included a neurocognitive component, often an important consideration in chronic illnesses that may result in compromise of central nervous system functioning. Although the CHBM has been used to predict medication use in children with common, minor ailments, it has never been applied to a chronic pediatric illness. In addition to applying this health belief model, we propose to include a neurocognitive factor to account for varying degrees of CMS compromise demonstrated in children with SCO. The neurocognitive factor will consist of measures of prospective memory (remembering to perform actions in the future) and sustained attention (vigilance) as these cognitive processes are hypothesized to be important in performing self-management behaviors. The plan is to test the addition of this neurocognitive factor to a subsection of the full CHBM including only the statistically significant major pathways found to be important in medication use (which is a subset of self-management behaviors). We hypothesize that the subsection of the causal model will account for a significant portion of the variance in self-management behaviors. Further, the addition of the neurocognitive factor (primarily focusing on prospective memory) will significantly improve the variance accounted for in self-management. These data will allow for the testing of the full CHBM model in a future study with a larger sample of children with SCO, and provide guidance as to which pathways would be most amenable to intervention directed at improving self-management behaviors, and ultimately improving the quality of life for children with SCO. Relevance: This project will help identify behaviors, mental abilities, and beliefs that contribute to how well a child performs SCO self-manage behaviors to maintain optimal health. The model being tested will help identify areas (behaviors and health beliefs) that could be targeted through intervention programs to help children self-manage their SCO more effectively to maintain optimal health.

描述（由申请人提供）： 项目摘要：这个为期 2 年的试点项目（响应 PA 03-159）的主要目标是应用儿童健康信念模型 (CHBM) 来预测 6 岁儿童的自我管理行为-13 岁患有镰状细胞病 (SCO)。随着这些孩子年龄的增长，他们对疾病管理的责任也越来越大。这可能涉及预防措施和药物治疗。预测儿童医疗自我管理和依从性结果的模型主要关注特定的环境和心理社会因素（例如动机、感知威胁、冒险行为、社会经济地位等），但没有使用更完整的模型将这些因素结合起来专门解决患有慢性疾病的儿童，包括 SCO 此外，迄今为止还没有模型包含神经认知成分，这通常是可能导致中枢神经系统功能受损的慢性疾病的重要考虑因素。尽管 CHBM 已被用于预测患有常见小病的儿童的药物使用情况，但它从未应用于慢性儿科疾病。除了应用这种健康信念模型之外，我们建议纳入一个神经认知因素来解释 SCO 儿童表现出的不同程度的 CMS 损害。神经认知因素将包括前瞻性记忆（记住将来要执行的操作）和持续注意力（警惕性）的测量，因为这些认知过程被假设对执行自我管理行为很重要。该计划是测试将这种神经认知因素添加到完整 CHBM 的一部分中，其中仅包括在药物使用中发现重要的统计显着的主要途径（这是自我管理行为的一个子集）。我们假设因果模型的一部分将解释自我管理行为差异的很大一部分。此外，添加神经认知因素（主要关注前瞻性记忆）将显着改善自我管理中的方差。这些数据将允许在未来的研究中使用更大的 SCO 儿童样本来测试完整的 CHBM 模型，并为哪些途径最适合旨在改善自我管理行为的干预提供指导，并最终改善SCO 儿童的生活质量。相关性：该项目将帮助识别有助于儿童如何更好地执行 SCO 自我管理行为以保持最佳健康的行为、心理能力和信念。正在测试的模型将有助于确定干预计划可以针对的领域（行为和健康信念），以帮助儿童更有效地自我管理他们的 SCO，以保持最佳健康。