Optimizing Chronic Illness Self-Management for Individuals with Schizophrenia

优化精神分裂症患者的慢性病自我管理

基本信息

批准号：
7257685
负责人：
RICHARD Warren GOLDBERG
金额：
$ 20.94万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-03-28 至 2010-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7257685
关键词：
Accounting Address Adult Advocate Affect Americas Attention Behavioral Caring Chronic Chronic Care Chronic Disease Cognitive Comorbidity Condition Consumer Participation Diabetes Mellitus Disabled Persons Educational Curriculum Effectiveness Effectiveness of Interventions Face Freedom Future General Population Goals HIV Health Health Care Costs Health Personnel Health Promotion Health Status Health system Heart Diseases Hepatitis C Individual Infection Intervention Life Manuals Measures Medical Mental Health Mental Health Services Mental disorders Methods Modification Monitor Morbid Obesity Morbidity - disease rate Neurocognition Numbers Outcome Participant Patient Education Patient-Centered Care Patients Pattern Persons Pharmaceutical Preparations Population Study Procedures Provider Psyche structure Public Health Quality of Care Quality of life Randomized Controlled Trials Range Rate Recovery Rehabilitation therapy Relative (related person)Reliance Research Research Project Grants Schizophrenia Self Care Self Efficacy Self Management Services Smoke Solid Structure Substance abuse problem Surgeon Symptoms System Testing Weight Wellness Program abstracting base cost disability experience functional disability handbook improved innovation mortality peer pilot trial programs respiratory severe mental illness skills social social communication therapy development

项目摘要

DESCRIPTION (provided by applicant): Abstract Recovery is cited within Transforming Mental Health Care in America, Federal Action Agenda: First Steps, as the "single most important goal" for the mental health service delivery system. Increasingly, physical wellness is being recognized as a key component of a more holistic approach to recovery. The elevated rates of medical co-morbidity among individuals with schizophrenia represent a significant public health challenge with profound service delivery, cost and quality implications. Innovative and portable interventions are sorely needed to more effectively address this problem. Despite the growing recognition that self-management strategies hold enormous promise for improving quality and outcomes of care for chronic medical illnesses, and the fact that self-management is gaining prominence as a recovery oriented treatment focus, relatively little is known about how to extend use of effective medical self-care programs to help persons with schizophrenia more actively participate in their health and medical care management. To address this gap, our R34 application meets the objectives of PAR-06-248 "From Intervention Development to Services: Exploratory Research Grants (R34)" and proposes to develop and pilot test an optimized version of an existing and effective chronic medical illness self-management program to better meet the needs adults with schizophrenia. Our specific aims are to: 1. Develop intervention materials and a manual for the proposed adapted chronic medical illness self management intervention. 2. Refine materials and implementation procedures based on a preliminary, short-term trial with 6-8 patients. 3. Implement a carefully monitored pilot trial for 50 participants and measure the effect at 6 months on the primary outcomes of: a) health related self-efficacy and recovery orientation; b) medical illness self-management skills; c) social/communication skills focusing on interactions with health care providers; d) physical and mental health status; and f) medical service use patterns. Secondary, exploratory analyses will examine the modifying effect of various covariates on the effectiveness of the intervention including medication use, neurocognition, substance abuse, psychiatric symptoms, number of and seriousness of related comorbidities, and quantitative and qualitative ratings of consumer participation in the intervention. This R34 application meets the objectives of PAR-06-248 "From Intervention Development to Services: Exploratory Research Grants (R34)" and proposes to develop and pilot test an optimized version of an existing and effective chronic medical illness self-management program to better meet the needs adults with schizophrenia.

描述（由申请人提供）：摘要《美国精神卫生保健转型》《联邦行动议程：第一步》中引用了恢复作为精神卫生服务提供系统的“最重要的目标”。身体健康越来越被认为是更全面的康复方法的关键组成部分。精神分裂症患者的医疗共病率升高是一项重大的公共卫生挑战，对服务提供、成本和质量产生深远影响。迫切需要创新和便携式干预措施来更有效地解决这一问题。尽管人们越来越认识到自我管理策略对于提高慢性疾病护理的质量和结果具有巨大的希望，而且自我管理作为以康复为导向的治疗重点越来越受到重视，但人们对如何扩展使用知之甚少。有效的医疗自我护理计划，帮助精神分裂症患者更积极地参与健康和医疗护理管理。为了弥补这一差距，我们的 R34 应用程序满足 PAR-06-248“从干预开发到服务：探索性研究补助金 (R34)”的目标，并建议开发和试点测试现有有效慢性疾病自我的优化版本-更好地满足成人精神分裂症患者需求的管理计划。我们的具体目标是： 1. 为拟议的适应性慢性病自我管理干预措施制定干预材料和手册。 2. 根据6-8名患者的初步短期试验完善材料和实施程序。 3. 对 50 名参与者进行仔细监测的试点试验，并测量 6 个月时对以下主要结果的影响： a) 与健康相关的自我效能和康复方向； b) 医疗疾病自我管理技能； c) 注重与医疗保健提供者互动的社交/沟通技巧； d) 身心健康状况； f) 医疗服务使用模式。其次，探索性分析将检查各种协变量对干预措施有效性的修改作用，包括药物使用、神经认知、药物滥用、精神症状、相关合并症的数量和严重性，以及消费者参与干预的定量和定性评级。此 R34 申请符合 PAR-06-248“从干预开发到服务：探索性研究补助金 (R34)”的目标，并建议开发和试点测试现有有效慢性病自我管理计划的优化版本，以更好地满足成人精神分裂症患者的需求。