Coping Skills Training for Arthritis: An Effectiveness Trial

关节炎应对技能训练：有效性试验

基本信息

批准号：
7811890
负责人：
Joan E Broderick
金额：
$ 60.62万
依托单位：
STATE UNIVERSITY NEW YORK STONY BROOK
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-21 至 2012-09-20
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7811890
关键词：
Adaptive Behaviors Adoption Adult Advocate Affect Aftercare Age Age-Years American Arthritis Behavior Therapy Behavioral Behavioral Medicine Centers for Disease Control and Prevention (U.S.)Childhood Chronic Client satisfaction Clinical Trials Cognitive aging Communities Computers Consumer Satisfaction Control Groups Coping Skills Data Degenerative polyarthritis Diagnosis Disease Progression Effectiveness Elderly Ensure Face Frequencies Frustration Future Goals Health Personnel Health Professional Healthcare Healthy People 2010 Housing Impairment Individual Information Systems Internet Intervention Learning Living Wills Low Back Pain Maintenance Measures Medical Mental Health Methods Modeling Monitor Moods Nurse Practitioners Nurses Older Population Outcome Outcome Assessment Outcome Measure Pain Pain Measurement Pain management Patient Education Patients Persons Pharmaceutical Preparations Population Primary Health Care Provider Psychological reinforcement Public Health Quality of life Randomized Randomized Controlled Trials Recruitment Activity Research Research Design Research Project Grants Science Self Care Self Efficacy Sensory Services Social Functioning Solutions Staging Surveys System Target Populations Techniques Technology Telephone Testing Therapeutic Therapeutic Effect Therapeutic Uses Time Training Treatment Efficacy Universities Vermont Voice Work arthritis education base chronic pain coping cost cost effective cost effectiveness design disability disorder later incidence prevention effectiveness clinical trial effectiveness research effectiveness trial efficacy trial experience functional disability health care delivery health economics health related quality of life improved improved functioning innovation interest middle age model design multi-site trial new technology novel therapeutics older patient programs prospective psychologic psychological distress public health relevance rehearsal response skills skills training therapy design treatment as usual treatment program treatment response uptake usability user-friendly willingness

项目摘要

DESCRIPTION (provided by applicant): The leading cause of disability in the U.S.is arthritis, affecting approximately 60% of those over 65 years of age. Biomedical treatments are limited in their ability to curb osteoarthritis (OA) disease progression and to eliminate pain and functional impairment. Health-related quality of life measures consistently document significant impairment in persons with arthritis. Efficacy trials have documented that Pain Coping Skills Training (CST) for arthritis reduces pain, improves physical and social functioning, increases self-efficacy, and reduces psychological distress. Despite this, CST is unavailable to the vast majority of OA patients. Increasing patient access to CST will require an innovative healthcare model. Ideally, CST should be integrated into patients' community medical settings. Among providers in these settings, nurse practitioners (NP) with their training in patient education, seem well-suited to deliver CST. This proposal is the first effectiveness trial -bringing CST from academic settings into community primary care offices where NPs will be trained to deliver manualized, 10-session CST. A randomized, controlled (treatment vs. usual care) multi- site trial (N=272) for OA patients with chronic pain is proposed. Intent-to-treat analyses will evaluate whether this treatment delivery model yields significant benefits compared with a usual-care control group. Assessments of pain, physical and psychological disability, self-efficacy, pain coping skills, and quality of life will be conducted pre-treatment, post-treatment, and at 6-month, 1-, 2-year follow-ups. Cost-effectiveness analyses will be conducted. This study will make important contributions to the science of effectiveness research through comprehensive assessment of outcomes specific to effectiveness research. Analyses will examine reach into the target population, assessment of treatment fidelity by NPs, patient uptake of treatment, consumer satisfaction, and utilization of medication and other arthritis treatments. If this trial is successful, it will set the stage for subsequent studies to investigate innovative strategies to enhance maintenance of CST effects, to incorporate telephone and computer delivery of CST, and to conduct health economic analyses. PUBLIC HEALTH RELEVANCE: This research will test an innovative health care delivery model designed to make pain coping skills training (CST) more widely available to patients with arthritis. CST has been shown to improve patients' functioning and quality of life beyond what medications and other medical treatment offer.

描述（由申请人提供）：在美国，导致残疾的主要原因是关节炎，约 60% 的 65 岁以上老年人受到影响。生物医学治疗在抑制骨关节炎 (OA) 疾病进展以及消除疼痛和功能障碍方面的能力有限。与健康相关的生活质量测量始终记录关节炎患者的显着损害。功效试验表明，针对关节炎的疼痛应对技能训练 (CST) 可减轻疼痛、改善身体和社会功能、提高自我效能并减少心理困扰。尽管如此，绝大多数 OA 患者无法进行 CST。增加患者获得 CST 的机会需要创新的医疗模式。理想情况下，CST 应融入患者的社区医疗环境。在这些环境中的提供者中，接受过患者教育培训的执业护士 (NP) 似乎非常适合提供 CST。该提案是第一个有效性试验 - 将 CST 从学术环境引入社区初级保健办公室，在那里 NP 将接受培训以提供手动的、10 次 CST。建议对患有慢性疼痛的 OA 患者进行一项随机对照（治疗与常规护理）多中心试验 (N=272)。意向治疗分析将评估这种治疗提供模式与常规护理对照组相比是否产生显着益处。将在治疗前、治疗后以及 6 个月、1 年、2 年随访时对疼痛、身体和心理残疾、自我效能、疼痛应对技能和生活质量进行评估。将进行成本效益分析。这项研究将通过对有效性研究的具体结果进行综合评估，为有效性研究科学做出重要贡献。分析将检查目标人群的覆盖范围、NP 治疗保真度的评估、患者对治疗的接受情况、消费者满意度以及药物和其他关节炎治疗的利用。如果这项试验成功，将为后续研究奠定基础，以调查增强 CST 效果维持的创新策略、纳入 CST 的电话和计算机交付以及进行健康经济分析。公共健康相关性：这项研究将测试一种创新的医疗保健提供模式，旨在使关节炎患者更广泛地获得疼痛应对技能培训 (CST)。 CST 已被证明可以改善患者的功能和生活质量，其效果超出了药物和其他医疗方法。