Internet-based osteoarthritis pain coping skills intervention

基于互联网的骨关节炎疼痛应对技能干预

基本信息

批准号：
8287659
负责人：
Christine Rini
金额：
$ 65.86万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-20 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8287659
关键词：
Address Adherence Adult Adverse effects Age American Anxiety Area Arthritis Articular Range of Motion Behavior Behavioral Cognitive Cognitive Therapy Computers Controlled Study Coping Skills Degenerative polyarthritis Direct Costs Distress Education Educational Intervention Educational process of instructing Effectiveness Ensure Event Expert Systems Facilities and Administrative Costs Feedback Feeling Focus Groups Funding Future Goals Health Health Care Visit Health behavior Home environment Hour Improve Access Individual Inflammation Internet Intervention Joints Learning Length of Stay Life Light Medical Modeling Motivation Multimedia Non-Steroidal Anti-Inflammatory Agents Older Population Pain Pain intensity Pain interference Pain management Patient Care Patients Persons Pharmaceutical Preparations Phase Population Preparation Problem Solving Programmed Learning Protocols documentation Public Health Quality of life Randomized Randomized Controlled Trials Relaxation Reporting Research Rest Risk Role Safety Self Management Site Social Reinforcement Source Staging Steroids Stigmata Techniques Technology Testing Thinking Time Training Translating Translations Travel Work arthropathies base compliance behavior computerized coping cost cost effective design disability distraction effective intervention experience hazard high risk individualized feedback information gathering innovative technologies meetings programs psychologic psychological distress psychosocial public health relevance skills skills training social cognitive theory social stigma technology development therapy design tool treatment as usual usability user-friendly

项目摘要

DESCRIPTION (provided by applicant): Twenty-one million Americans live with osteoarthritis (OA), a progressive joint disease that causes stiffness, pain, reduced range of motion, distress, and decrements in physical, social, and role functioning. Medical treatments for OA pain are limited and present risks, especially for older populations. However, cognitive behavioral pain coping skills interventions have proven effective for decreasing OA pain, disability, and distress. Unfortunately, existing programs reach a limited number of patients because they require patients to travel to receive in-person training. There is a need for interventions that address the needs of a larger proportion of the rapidly growing population of people whose functioning and quality of life are severely diminished by OA. Delivering proven pain management interventions via the Internet is a promising way to address this need, especially in light of increasing use of the Internet by older Americans. To be most effective, an Internet-based intervention would need to mimic key features of in-person interventions. The proposed intervention will do that by translating a proven in-person pain coping skills protocol into an interactive Internet- based application that uses multimedia and expert systems technology to mimic in-person interventions. It will provide individualized feedback, interactive problem solving, and animated demonstrations, and it will incorporate learning techniques from Bandura's Social Cognitive Theory, including modeling, mastery experiences, and social reinforcement. The project includes two phases, corresponding to two specific aims. In Phase I we will translate the in-person intervention for delivery on the Internet. This phase will including gathering feedback from patient and expert therapist focus groups, which will help refine the program. In Phase II we will conduct a small-scale randomized controlled trial that will enable us to examine and refine features designed to increase motivation and adherence over the course of the 8-week Internet-based intervention. The trial will also enable us to demonstrate its feasibility, tolerability, safety, and promise. We hypothesize that the trial will demonstrate the effectiveness of the Internet for delivery of this OA pain coping skills intervention. Taken together, these activities will prepare the program for testing in a full-scale randomized controlled trial in the next stage of this research. The promise of this project is enhanced by the multi-disciplinary research team, which has expertise in the conduct of cognitive behavioral interventions that teach OA patients to use coping skills to manage their pain, developing and implementing individualized computerized feedback reports using expert systems technology, and development of engaging, user-friendly, interactive computer-based programs for learning and assessment. Relevance: This Internet-based OA pain coping skills intervention targets a significant individual and public health problem and expands access to an empirically-supported pain self- management program so that it can reach a greater proportion of the large and growing population of people suffering from OA pain and related disability. PUBLIC HEALTH RELEVANCE: This project will translate a proven pain coping skills intervention for osteoarthritis (OA) patients into an engaging and easy-to-use Internet-based intervention that uses innovative technologies to mimic traditional, in- person training sessions. A significant benefit of this approach is its promise for extending the reach of an efficacious treatment to a larger proportion of the growing population of OA patients, for instance, those who are unable or unwilling to travel for training. If found to be effective, this Internet-based OA pain coping skills intervention will be a valuable tool for addressing the needs of the millions of Americans whose functioning and quality of life are severely diminished by OA pain and disability.

描述（由申请人提供）：200万美国人患有骨关节炎（OA），这是一种渐进的关节疾病，会导致僵硬，疼痛，运动范围减少，身体，社交和角色功能减少。 OA疼痛的医疗治疗有限，并且目前的风险，尤其是对于老年人。但是，认知行为疼痛应对技巧的干预措施已被证明有效地减轻了OA疼痛，残疾和困扰。不幸的是，现有计划达到了有限数量的患者，因为他们要求患者旅行接受面对面的培训。有必要采取干预措施来满足更大比例的快速增长的人群的需求，其功能和生活质量被OA严重降低。通过互联网提供验证的疼痛管理干预措施是满足这种需求的一种有希望的方法，尤其是鉴于老年人对互联网的使用增加。为了最有效，基于互联网的干预措施需要模仿面对面干预的关键特征。拟议的干预措施将通过将经过验证的面对面痛苦技能协议转化为基于交互式的互联网应用程序，该应用程序使用多媒体和专家系统技术来模仿亲自干预。它将提供个性化的反馈，交互式问题解决和动画演示，并将结合班杜拉（Bandura）社会认知理论的学习技巧，包括建模，精通经验和社会增强。该项目包括两个阶段，对应于两个特定目标。在第一阶段，我们将翻译在互联网上交付的面对面干预措施。此阶段将包括收集患者和专家治疗师焦点小组的反馈，这将有助于完善该计划。在第二阶段，我们将进行一项小规模的随机对照试验，该试验将使我们能够检查和完善旨在在为期8周的基于Internet的干预过程中提高动力和依从性的功能。该试验还将使我们能够证明其可行性，容忍性，安全性和承诺。我们假设该试验将证明互联网在交付这种OA疼痛应对技能干预措施方面的有效性。综上所述，这些活动将为该计划的下一阶段的全尺度随机对照试验做准备。多学科研究团队增强了该项目的承诺，该团队在认知行为干预措施的进行方面具有专业知识，这些干预措施教会OA患者使用应对技巧来管理其痛苦，使用专家系统技术以及开发引人入胜的，用户友好的，互动的基于计算机的学习和评估的计算机化计算机反馈报告。相关性：这种基于互联网的OA疼痛应对能力的干预措施针对一个重大的个人和公共卫生问题，并扩大了对经验支持的疼痛自我管理计划的访问，以便它可以达到较大且不断增长的患有OA疼痛和相关残疾的人群的比例。公共卫生相关性：该项目将转化为骨关节炎（OA）患者的可靠疼痛技巧干预措施为一种引人入胜且易于使用的基于Internet的干预措施，该干预使用创新技术来模仿传统的传统，人体培训。这种方法的一个重大好处是，它有望将有效治疗的范围扩展到不断增长的OA患者人群中的比例，例如那些无法或不愿意旅行的人。如果发现有效，这种基于Internet的OA疼痛应对技巧干预将是满足数百万美国人需求的宝贵工具，这些工具的功能和生活质量因OA疼痛和残疾而严重降低。