Restricting Back Pain in Community-Living Older Persons: A Mixed-Methods Approach

限制社区生活老年人的背痛：混合方法

• 批准号: 8183722
• 负责人: UNA E. MAKRIS
• 金额: $ 8.28万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8183722
• 关键词: Activities of Daily Living; Adult; Age; Attitude; Back; Back Pain; Data; Development; Dimensions; Disease; Elderly; Enrollment; Ensure; Event; Family; Frequencies; Future; Home environment; Intervention; Interview; Learning; Life; Literature; Longitudinal Studies; Methods; Outcome; Participant; Persons; Population; Qualitative Methods; Reporting; Research; Research Proposals; Severities; Structure; Time; base; cohort; community living; disability; evidence base; experience; follow-up; improved; innovation; middle age; novel; older men; older women; psychologic; sex; social; tool; trend

DESCRIPTION (provided by applicant): Although back pain is a highly common and costly disorder, most of the literature has focused on young to middle-aged adults. Preliminary research from this candidate shows that back pain in older persons, severe enough to result in restricted activity (restricting back pain), is both common and frequently episodic. While restricting back pain in older persons is common, much remains to be learned about its impact and burden of suffering in later life. The overall objective of this R03 proposal is to determine, using mixed (quantitative and qualitative) methods, the impact of restricting back pain in older persons. The specific aims of the current proposal are 1) to elucidate the relationship between restricting back pain and subsequent (new or increasing) disability in activities of daily living (ADL) and mobility in older persons and, 2) to explore older persons' perspectives, experiences, and attitudes regarding how restricting back pain impacts daily life from multiple dimensions, including social, physical, and psychological. We hypothesize that a greater number and duration of restricting back pain episodes will be associated with more frequent occurrence of new or increasing disability in ADL and mobility. We anticipate that our qualitative results will provide a more comprehensive understanding of the burden of restricting back pain, in richer detail than what is available from quantitative analyses alone. To accomplish our aims, we will use data from the Yale Precipitating Events Project (PEP), a unique and highly innovative cohort of 754 non-disabled, community-living persons, over the age of 70 at enrollment. Participants have completed comprehensive, home-based assessments at 18-month intervals as well as monthly assessments of restricting back pain and disability for 12+ years. Because certain questions cannot be readily answered using quantitative data alone, we will also conduct in-depth interviews with older persons with restricting back pain to ensure that we capture the range of experiences from the older persons' perspective. Of immediate relevance, our results will provide clinicians, older persons who experience this disorder, and their families, with innovative, novel, and more accurate information that reflects the burden of restricting back pain in older persons. Ultimately, a better understanding of the burden and impact of restricting back pain is a necessary step that may be used to inform development of effective age- and sex-appropriate assessment tools and interventions to improve outcomes of this common condition in older persons. PUBLIC HEALTH RELEVANCE: Although back pain is a highly common and costly disorder, much remains to be learned about its impact and burden of suffering in later life. The proposed research in this R03 application will use mixed methods (quantitative and qualitative) to provide novel, high-quality, evidence-based information on the impact of restricting back pain (back pain severe enough to result in restricted activity) using data from a large cohort of community-living older persons followed for over 12 years. Ultimately, the results of this study will provide a better understanding of the burden and impact of restricting back pain that may be used to inform development of effective age- and sex-appropriate assessment tools and interventions to improve outcomes of this common condition in older persons.

描述（由申请人提供）：虽然背痛是一种非常常见且昂贵的疾病，但大多数文献都集中在年轻人到中年人身上。该候选人的初步研究表明，老年人的背痛很常见，而且经常发作，严重程度足以导致活动受限（限制背痛）。虽然限制老年人的背痛很常见，但关于其对晚年生活的影响和痛苦负担仍有待了解。该 R03 提案的总体目标是使用混合（定量和定性）方法确定限制老年人背痛的影响。当前提案的具体目标是 1) 阐明限制背痛与老年人日常生活活动 (ADL) 和活动能力的后续（新的或增加的）残疾之间的关系，2) 探索老年人的观点，关于限制背痛如何从多个维度（包括社会、身体和心理）影响日常生活的经验和态度。我们假设，限制性背痛发作的次数和持续时间越多，与新的或增加的日常生活能力和活动能力残疾的发生越频繁相关。我们预计，我们的定性结果将提供对限制背痛负担的更全面的了解，比仅从定量分析中获得的信息更详细。为了实现我们的目标，我们将使用耶鲁大学突发事件项目 (PEP) 的数据，该项目是一个独特且高度创新的队列，由 754 名非残疾人、社区生活人员组成，入组时年龄超过 70 岁。参与者每 18 个月完成一次全面的家庭评估，以及 12 年以上限制背痛和残疾的每月评估。由于仅使用定量数据无法轻松回答某些问题，因此我们还将对患有限制性背痛的老年人进行深入访谈，以确保我们从老年人的角度捕捉各种经历。具有直接意义的是，我们的结果将为临床医生、患有这种疾病的老年人及其家人提供创新、新颖和更准确的信息，反映限制老年人背痛的负担。最终，更好地了解限制背痛的负担和影响是必要的一步，可用于为开发有效的适合年龄和性别的评估工具和干预措施提供信息，以改善老年人这种常见病症的结果。 公众健康相关性：虽然背痛是一种非常常见且代价高昂的疾病，但关于其对晚年生活的影响和痛苦负担仍有很多知识需要了解。 R03 申请中拟议的研究将使用混合方法（定量和定性），利用来自以下机构的数据，提供关于限制背痛（背痛严重到足以导致活动受限）的影响的新颖、高质量、基于证据的信息。对一大批社区生活的老年人进行了超过 12 年的跟踪调查。最终，这项研究的结果将有助于更好地了解限制背痛的负担和影响，这可用于为开发有效的适合年龄和性别的评估工具和干预措施提供信息，以改善老年人这种常见病症的结果。