HRT Decision Support for Women with Mobility Impairment

为行动不便的女性提供 HRT 决策支持

• 批准号: 6664779
• 负责人: HEATHER A BECKER
• 金额: $ 14.79万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2006-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6664779
• 关键词: behavioral /social science research tag; clinical research; counseling; decision making; disease /disorder proneness /risk; education evaluation /planning; female; health behavior; health education; health services research tag; hormone therapy; human middle age (35-64); human subject; menopause; nursing intervention; outcomes research; person with disability; preference; psychological stressor; psychological values; publications; satisfaction; vasomotion; women's health

DESCRIPTION (provided by applicant): Healthy People 2010, the American Nurses Association, and the American College of Physicians have all recommended that mid-life women be counseled about the risks and benefits of hormone replacement therapy (HRT). Conflicting scientific evidence about long-term outcomes has made HRT use controversial. Menopausal women, however, cannot wait until the scientific evidence becomes more decisive to make this decision. In such an uncertain decision environment, nursing interventions are most needed to address the unsure and/or value sensitive nature of the risks and benefits associated with this decision (O'Connor, 1988). Women with mobility impairments face special challenges regarding HRT use. Because they enter menopause with decreased weight bearing and aerobic activity histories, they may be at greater risk for Osteoporosis and cardiovascular disease. Women who experience temperature fluctuations as part of their disability may find the Vasomotor instability that can occur during menopause particularly troublesome. While HRT might be particularly beneficial to these women, they may also be at increased risk of thrombosis. Consequently, existing information about the risks and benefits associated with HRT use must be tailored to the special needs of this population. Previous research has indicated that, following use of a theoretically based decision support intervention, non-disabled women increased their HRT knowledge, congruence between personal values and choices, satisfaction with the decision, and decreased their decisional conflict (O'Connor, et al., 1998). The aim of this study is to test an adapted version of this intervention, designed to assist women with mobility impairments in making informed choices about HRT use. Two hundred mid-life women with mobility impairments will be randomly assigned either to a decision support intervention, which has been adapted to their special needs, or to a standard educational pamphlet. Multiple Analysis of Variance will be used to assess changes in decision outcomes from pre-intervention to immediate post-intervention and 6 months following the intervention. Findings from this study will assist nurses and other providers to counsel women with mobility impairments about key health care decisions during menopause.

描述（由申请人提供）：2010年健康人，美国护士协会和美国医师学院都建议对中年妇女进行有关激素替代疗法（HRT）的风险和益处的建议。关于长期结局的科学证据相互矛盾，使HRT使用了有争议。但是，更年期妇女迫不及待地等到科学证据变得更加决定性做出这一决定。在这种不确定的决策环境中，最需要采取护理干预措施来解决与此决定相关的风险和收益的不确定和/或价值敏感性（O'Connor，1988）。流动性障碍的妇女在使用HRT方面面临特殊挑战。由于它们进入更年期，重量轴承和有氧活动史减少，因此它们可能面临骨质疏松症和心血管疾病的风险更大。 经历温度波动作为残疾的一部分的妇女可能会发现更年期期间可能发生的血管舒缩不稳定特别麻烦。尽管HRT可能对这些女性特别有益，但她们也可能会增加血栓形成的风险。因此，必须根据该人群的特殊需求来量身定制有关与HRT使用相关的风险和利益的现有信息。先前的研究表明，在使用基于理论上的决策支持干预措施后，非残疾妇女提高了她们的HRT知识，个人价值观和选择之间的一致性，对决定的满意度以及减少了决策冲突（O'Connor等，1998）。这项研究的目的是测试此干预措施的改编版本，旨在帮助有行动不便的女性做出有关HRT使用的明智选择。两百名具有行动障碍的中年妇女将被随机分配到已适应其特殊需求或标准教育小册子的决策支持干预措施中。多次方差分析将用于评估从干预前到立即干预后以及干预后6个月的决策结果的变化。这项研究的结果将帮助护士和其他提供者为在更年期期间有关关键医疗保健决定的行动不便的妇女提供咨询。