Dyspnea Self-Management: Internet or Face-to-Face

呼吸困难自我管理：互联网或面对面

基本信息

批准号：
7846883
负责人：
VIRGINIA Lee CARRIERI-KOHLMAN
金额：
$ 43万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-08-25 至 2011-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7846883
关键词：
Activities of Daily Living Acute Adherence Attention Chronic Disease Chronic Obstructive Airway Disease Communication Board Consultations Devices Dyspnea Education Elderly Emerging Technologies Environment Exercise Goals Health Communication Health Professional Health Resources Home environment Individual Internet Intervention Interview Learning Lung Lung diseases Maintenance Measurement Modeling Modification Monitor Outcome Patients Pattern Penetration Perception Performance Physical Function Physiological Pilot Projects Psychological reinforcement Randomized Research Personnel Self Efficacy Self Management Shortness of Breath Social support Symptoms Telephone Testing Text Virginia Wireless Technology Writing base behavior change disability evidence base improved insight longitudinal design meetings peer primary outcome programs satisfaction secondary outcome social cognitive theory

项目摘要

Dyspnea or shortness of breath is the most common disabling symptom in patients with chronic obstructive pulmonary disease (COPD). The increased availability and growing acceptance of emerging technologies as a channel for health communication has opened up opportunities to provide convenient and seamless support for self-management of dyspnea and related symptoms to greater numbers of individuals. The overall goal of this proposal is to compare the impact of a new Internet dyspnea self-management program (i-DSMP) with a face-to-face program (f-DSMP) that has been shown to be effective in patients with COPD. It is hypothesized that there will be no significant differences between the i-DSMP and the f-DSMP in the primary outcomes of dyspnea with ADL, pulmonary exacerbations, exercise performance and adherence secondary outcomes of perception of social support, self-efficacy for managing dyspnea exercise, health resource utilization, and satisfaction with program at 3,6, and 12 months. Secondary aims are to relate subject usage patterns and satisfaction to changes in outcomes and to describe changes in symptom clusters and exercise patterns before, during and after acute exacerbations. Subjects with COPD who are currently using the Internet (N= 200) will be randomized to i-DSMP, f-DSMP, or Attention Control. Guided by physiological concepts, Social Cognitive Theory, and the Transtheoretical Model, the programs include: 1) initial face-to-face dyspnea interview and exercise consultation, 2) dyspnea education, 3) individualized exercise program, 4) self monitoring of exercise and symptoms, and 5) reminders and reinforcement of exercise. The i-DSMP will use online interactive learning modules, text chats, and bulletin board for communication and education and a wireless device (PDA) for monitoring symptoms, exercise, and to receive reinforcement for exercise. The f-DSMP will meet face-to-face, use written logs, and receive telephone reinforcement. If this i-DSMP is as effective as the f-DSMP, it will represent a first step in establishing an evidence-base for widespread implementation of self-management programs for people with symptoms of chronic illness using the Internet and mobile environments.

呼吸困难或气短是慢性阻塞性肺病 (COPD) 患者最常见的致残症状。新兴技术作为健康传播渠道的可用性和接受度不断提高，为更多人提供便捷、无缝的呼吸困难及相关症状自我管理支持提供了机会。该提案的总体目标是比较新的互联网呼吸困难自我管理计划 (i-DSMP) 与已被证明对 COPD 患者有效的面对面计划 (f-DSMP) 的影响。假设 i-DSMP 和 f-DSMP 在 ADL 呼吸困难的主要结局、肺部恶化、运动表现和依从性、社会支持感知、管理呼吸困难的自我效能等次要结局方面没有显着差异3、6 和 12 个月时的锻炼、卫生资源利用以及对计划的满意度。次要目标是将受试者使用模式和满意度与结果变化联系起来，并描述急性加重之前、期间和之后症状群和运动模式的变化。当前正在使用互联网的 COPD 受试者 (N= 200) 将被随机分配到 i-DSMP、f-DSMP 或注意力控制组。以生理学概念、社会认知理论和跨理论模型为指导，项目包括：1）初步面对面的呼吸困难访谈和运动咨询，2）呼吸困难教育，3）个性化运动计划，4）运动和运动的自我监测症状，5）运动提醒和强化。 i-DSMP 将使用在线互动学习模块、文本聊天和公告板进行交流和教育，并使用无线设备 (PDA) 来监测症状、锻炼和接收锻炼强化。 f-DSMP 将进行面对面的会议、使用书面日志并接受电话增援。如果该 i-DSMP 与 f-DSMP 一样有效，它将代表在建立证据基础方面迈出的第一步，以便利用互联网和移动环境广泛实施针对患有慢性病症状的人的自我管理计划。