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）：2100 万美国人患有骨关节炎 (OA)，这是一种进行性关节疾病，会导致僵硬、疼痛、活动范围缩小、痛苦以及身体、社交和角色功能下降。骨关节炎疼痛的药物治疗有限且存在风险，尤其是对于老年人群。然而，认知行为疼痛应对技能干预措施已被证明可以有效减少骨关节炎疼痛、残疾和痛苦。不幸的是，现有计划覆盖的患者数量有限，因为它们需要患者前往接受现场培训。需要采取干预措施来满足快速增长的人口中较大比例的需求，这些人的功能和生活质量因骨关节炎而严重下降。通过互联网提供行之有效的疼痛管理干预措施是满足这一需求的一种有前途的方法，特别是考虑到美国老年人越来越多地使用互联网。为了最有效，基于互联网的干预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疼痛应对技能协议转化为基于互联网的交互式应用程序来实现这一点，该应用程序使用多媒体和专家系统技术来模仿面对面的干预措施。它将提供个性化反馈、交互式问题解决和动画演示，并将结合班杜拉社会认知理论的学习技术，包括建模、掌握经验和社会强化。该项目包括两个阶段，对应两个具体目标。在第一阶段，我们将把现场干预翻译为在互联网上进行。此阶段将包括收集患者和专家治疗师焦点小组的反馈，这将有助于完善计划。在第二阶段，我们将进行一项小规模随机对照试验，这将使我们能够检查和完善旨在提高为期 8 周的互联网干预过程中的动机和依从性的功能。该试验还将使我们能够证明其可行性、耐受性、安全性和前景。我们假设该试验将证明互联网在提供骨关节炎疼痛应对技能干预方面的有效性。总而言之，这些活动将为本研究下一阶段的全面随机对照试验的测试做好准备。多学科研究团队增强了该项目的前景，该团队拥有进行认知行为干预的专业知识，教导骨关节炎患者使用应对技能来管理他们的疼痛，使用专家系统技术开发和实施个性化的计算机化反馈报告，开发引人入胜、用户友好、交互式的基于计算机的学习和评估程序。相关性：这种基于互联网的 OA 疼痛应对技能干预措施针对重大的个人和公共健康问题，并扩大了获得经验支持的疼痛自我管理计划的机会，以便它能够惠及大量且不断增长的患有疼痛的人群中的更大比例。骨关节炎疼痛和相关残疾。公共健康相关性：该项目将把针对骨关节炎 (OA) 患者的行之有效的疼痛应对技能干预措施转化为一种引人入胜且易于使用的基于互联网的干预措施，该干预措施使用创新技术来模仿传统的面对面培训课程。这种方法的一个显着好处是它有望将有效治疗的范围扩大到不断增长的骨关节炎患者群体中的更大比例，例如那些无法或不愿意前往接受培训的患者。如果发现有效，这种基于互联网的骨关节炎疼痛应对技能干预措施将成为满足数百万美国人的需求的宝贵工具，这些美国人的功能和生活质量因骨关节炎疼痛和残疾而严重下降。