Parental adherence to CF homecare: research chaplaincy career commitment

家长对 CF 家庭护理的遵守：研究牧师职业承诺

• 批准号: 8128444
• 负责人: Daniel Huck Grossoehme
• 金额: $ 11.7万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-13 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8128444
• 关键词: Adherence; Adult; Affect; American; Antibiotics; Attitude; Award; Behavior; Behavioral Model; Belief; Caring; Child; Child health care; Childhood; Chronic Care; Chronic Disease; Chronically Ill; Collaborations; Competence; Counseling; Cross-Sectional Studies; Cystic Fibrosis; Data; Data Analyses; Diagnosis; Disease; Distal; Doctor of Philosophy; Emotional; Family; Goals; Health; Home Care Services; Home environment; Hospitalization; Inpatients; Institution; Intervention; Interview; Intravenous; Lead; Life; Link; Mediating; Medical; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Motivation; Outcome; Outcomes Research; Parents; Patients; Play; Positioning Attribute; Prevalence; Publications; Publishing; Quality of life; Questionnaires; Religion; Religion and Psychology; Religion and Spirituality; Research; Research Design; Research Methodology; Research Personnel; Resources; Role; Schools; Self Efficacy; Self Management; Sickle Cell Anemia; Site; Social support; Solid; Spirituality; Structure; Telephone; Testing; Time; Training; Work; base; career; career development; children with cystic fibrosis; coping; diaries; experience; improved; innovation; patient home care; patient oriented; programs; public health relevance; skills

DESCRIPTION (provided by applicant): Cystic fibrosis (CF) is a life-shortening disorder, the course of which is exacerbated by nonadherence to recommended medical treatments at home. While much is known about factors affecting adherence, less is known about the role of other factors, including spirituality. Objectives: The Candidate's long-term goal is to develop an independent research career as an academic research chaplain focused on the role of child health outcomes and spirituality. The specific outcomes for this are award are to: a) enhance my understanding and competence in mixed-methods research and outcomes research and b) obtain the necessary professional and academic skills to succeed as an independent investigator. Training: For my career development, I plan to take further training in specific qualitative and quantitative methods and data analysis. My mentorship team is comprised of experts in the fields of outcomes research, qualitative and quantitative methods, CF, and spirituality research: Michael Seid, PhD (sponsor), Joel Tsevat, MD, MPH (co-sponsor), Dennis Drotar, PhD (co-sponsor), Kenneth Pargament, PhD, Annette Mahoney, PhD, George Fitchett, D Min, PhD. Jeffrey Jacobson, PhD, Rhonda VanDyke, PhD and James Acton, MD. Research Design & Methods: The central hypothesis is that spirituality is a factor in the lives of parents of children with CF, spiritual constructs are related to adherence, and that this effect is at least partially mediated by attitudes towards treatment, subjective norms, and self-efficacy. This proposal consists of 3 projects involving a total of 124 parents of children with CF. Project 1 is a longitudinal qualitative study with 24 parents using semi-structured interviews to determine the role of spirituality for parents in relation to their child's health and their adherence intentions. Project 2 is a quantitative cross-sectional study of 100 parents using questionnaires and the Daily Phone Diary to quantify the degree to which spiritual variables are related to adherence intentions among parents of children with CF. Project 3 is a quantitative cross-sectional study of 100 parents using the data collected in Project 2 to determine the extent to which the relationship between spiritual variables and parental adherence are mediated by attitudes, norms and self-efficacy. The Candidate's contribution will be to integrate spirituality into an already existing behavioral model of adherence, and to understand how a parent's spirituality impacts their adherence intentions and behaviors. The proposed research is significant because this understanding will enable us to improve existing adherence interventions and thus child health outcomes. PUBLIC HEALTH RELEVANCE: Adherence to chronic care treatments is uniformly poor, resulting in additional missed days of school and work for children and parents, increased need for antibiotics (including intravenous home administration antibiotics by parents) and inpatient hospitalizations. Despite the documented importance of spirituality in American families, little effort has yet been made to explore its role in relation to parental adherence to their child's recommended home health care. This proposed study both creates an independent researcher and identifies potential enhancements to existing adherence-improving interventions by the inclusion of spirituality that would contribute to even greater adherence and thus improved child heath.

描述（由申请人提供）：囊性纤维化（CF）是一种寿命疾病，由于不遵守建议在家中推荐的医疗治疗而加剧了这种疾病。尽管对影响依从性的因素有很多了解，但对其他因素（包括灵性）的作用知之甚少。目的：候选人的长期目标是发展独立的研究职业，作为一项学术研究牧师，专注于儿童健康成果和灵性的作用。奖励的具体结果是：a）增强我在混合方法研究和成果研究中的理解和能力研究，b）获得成功成为独立研究者的必要专业和学术技能。培训：对于我的职业发展，我计划在特定的定性和定量方法和数据分析方面进行进一步的培训。 My mentorship team is comprised of experts in the fields of outcomes research, qualitative and quantitative methods, CF, and spirituality research: Michael Seid, PhD (sponsor), Joel Tsevat, MD, MPH (co-sponsor), Dennis Drotar, PhD (co-sponsor), Kenneth Pargament, PhD, Annette Mahoney, PhD, George Fitchett, D Min,博士学位。 Jeffrey Jacobson博士，Rhonda Vandyke博士和医学博士James Acton。研究设计与方法：中心假设是灵性是CF儿童父母的生活，精神构造与依从性有关，并且这种效应至少是由对治疗，主观规范和自我效能的态度的部分介导的。该提案由3个项目组成，涉及共有124名儿童的父母。项目1是一项纵向定性研究，对24位父母进行了半结构化访谈，以确定父母对孩子健康和坚持意图的灵性作用。项目2是对100位父母使用问卷和每日电话日记的定量横断面研究，以量化精神变量与CF儿童父母的依从性有关的程度。项目3是使用项目2中收集的数据对100个父母进行的定量横断面研究，以确定精神变量与父母依从性之间的关系的程度是由态度，规范和自我效能感介导的。候选人的贡献是将灵性纳入已经存在的依从性行为模型，并了解父母的灵性如何影响其依从性和行为。拟议的研究很重要，因为这种理解将使我们能够改善现有的依从性干预措施，从而改善儿童健康成果。 公共卫生的相关性：遵守慢性护理治疗的依恋统一，导致额外的学校和父母的工作时间，对儿童和父母的工作，对抗生素的需求增加（包括父母静脉注射家庭管理抗生素）和住院住院治疗。尽管有记录在美国家庭中灵性的重要性，但尚未努力探索其与父母遵守孩子推荐的家庭医疗保健有关的作用。这项提出的研究既创造了独立的研究人员，又通过纳入灵性，可以确定对现有依从性改善干预措施的潜在增强，这将有助于更大的依从性并从而改善儿童健康。