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：这项为期两年的试点项目的主要目标（响应PA 03-159）是应用儿童健康信念模型（CHBM）来预测6-13岁儿童患有镰状细胞病（SCO）的儿童的自我管理行为（SCO）。随着这些孩子的年龄增长，他们对疾病管理的责任越来越多。这可能涉及预防措施和药物。预测儿童医学自我管理和依从性结果的模型主要集中在特定的环境和心理社会因素上（例如动机，感知的威胁，冒险行为，社会经济状况等），但并未将这些因素组合起来更完整地建模来结合使用这些因素，以使儿童与慢性医疗疾病的特定疾病相处，包括较长的疾病，包括较成熟的疾病，涉及更典型的疾病，一定要有成年的疾病，而这种疾病的范围是一定程度上的，而又有成年的疾病，并且构成了一个疾病，而又有成年的繁殖范围是一定程度上的。导致中枢神经系统功能的妥协。尽管CHBM已被用来预测常见，次要疾病的儿童的药物使用，但从未应用于慢性小儿疾病。除了应用这种健康信念模型外，我们还建议包括神经认知因素，以说明SCO儿童中所证明的CMS妥协的不同程度。神经认知因素将包括预期记忆的度量（记住将来采取行动）和持续的注意（警惕），因为这些认知过程被认为对执行自我管理行为很重要。该计划是将这种神经认知因子的添加到整个CHBM的一部分中，包括仅统计上重要的主要途径在药物使用中很重要（这是自我管理行为的一部分）。我们假设因果模型的小节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（主要集中在前瞻性记忆上）将显着改善自我管理中的差异。这些数据将允许在未来的研究中测试完整的CHBM模型，并提供更大的SCO儿童样本，并提供指导，以指导哪种途径最适合旨在改善自我管理行为的干预措施，并最终改善SCO儿童的生活质量。相关性：该项目将有助于确定行为，心理能力和信念，这些行为有助于儿童执行SCO自我管理行为以保持最佳健康状况。正在测试的模型将有助于确定可以通过干预计划来针对的领域（行为和健康信念），以帮助孩子更有效地自我管理SCO以保持最佳健康。