Self-Management in Chronic Kidney Disease

慢性肾脏病的自我管理

• 批准号: 9396428
• 负责人: Sarah Jeanne Schrauben
• 金额: $ 6.98万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-30 至 2018-06-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9396428
• 关键词: Affect; Age-Years; Area; Award; Behavior; Biometry; Blood Glucose; Blood Pressure; Body Weight; Cardiovascular Diseases; Cardiovascular system; Caring; Cessation of life; Characteristics; Chronic Disease; Chronic Kidney Failure; Chronic Kidney Insufficiency; Clinical; Cohort Studies; Data; Data Quality; Diabetes Mellitus; Dialysis procedure; Diet; Disease; Disease Outcome; Disease Progression; Economic Burden; End stage renal failure; Epidemic; Etiology; Event; Fellowship; Health; Health Status; Health behavior; Hospitalization; Individual; Intervention; K-Series Research Career Programs; Knowledge; Manuscripts; Measures; Mentors; Mentorship; Names; National Research Service Awards; Outcome; Participant; Patient Self-Report; Patients; Pattern; Pharmaceutical Preparations; Phase; Physical activity; Population; Practice Management; Prospective cohort study; Publications; Research; Research Personnel; Risk; Role; Self Efficacy; Self Management; Social support; Statistical Data Interpretation; Subgroup; Syndrome; Time; Tobacco use; Training; United States; aging population; behavior change; blood pressure reduction; career; career development; clinical epidemiology; cognitive function; cohort; glycemic control; health economics; health literacy; health related quality of life; healthy lifestyle; high risk; high risk population; improved; insight; interest; novel; patient oriented research; prevent; psychosocial; skills

PROJECT SUMMARY Chronic kidney disease (CKD) is a growing epidemic in the United States, and continues to increase with the aging population. CKD is generally progressive and irreversible, with complications including cardiovascular disease and progression to end-stage renal disease. Consequently, there is a compelling need to reduce the complications of CKD. Unfortunately, managing CKD is limited by the lack of disease-specific treatments, and we must rely on broad, indirect strategies to reduce the risk of poor CKD outcomes. These strategies rely heavily on CKD patients to actively participate in behavior changes that promote health and manage the disease (e.g., adhere to blood pressure medications, participate in healthy behaviors, etc.), collectively referred to as self- management behaviors. To date, research of self-management among those with pre-dialysis CKD is limited, although early CKD is arguably the most critical time to limit disease progression and prevent complications. The overall objectives of this study, within the Chronic Renal Insufficiency Cohort (CRIC) Study, a large pre-dialysis CKD cohort, include: 1) describing engagement in CKD self-management behaviors overall and by key characteristics, 2) exploring for sub-groups of individuals with specific patterns of CKD self-management engagement, 3) assessing for potential predictors of engaging in CKD self-management behaviors, and 4) investigating the association of CKD self-management engagement with long and short term clinical outcomes. Through these initial analyses, we aim to gain insights into CKD self-management engagement and its association to clinical outcomes in a pre-dialysis CKD cohort. We anticipate this project will yield critical insights into the clinical factors associated with CKD self-management engagement and will generate new hypotheses to drive future research in the area of improving CKD self-management through the identification of barriers to self-management engagement and groups at the highest risk for poor outcomes. The proposed application for the NRSA fellowship award will provide Dr. Schrauben with intensive training in clinical epidemiology, biostatistics, health behavior and health literacy research, multifaceted career development with complementary mentors with diverse backgrounds, support her to generate high-quality data, perform statistical analysis, interpret the findings, and prepare manuscripts for publication. Ultimately, Dr. Schrauben will gain skills that will enable her to mature as an investigator and compete successfully for a K- level career development award to further understand the role of self-management in CKD and help inform targeted interventions in high-risk groups.

项目摘要 慢性肾脏疾病（CKD）在美国越来越多，随着 人口老龄化。 CKD通常是渐进的和不可逆的，并发症包括 心血管疾病和末期肾脏疾病的发展。因此，有迫切的需求 减少CKD的并发症。 不幸的是，管理CKD受到缺乏特定疾病治疗的限制，我们必须依靠 降低CKD结果风险的广泛，间接策略。这些策略在很大程度上取决于CKD 患者积极参与促进健康和管理疾病的行为改变（例如，遵守 进行血压药物，参与健康行为等），共同称为自我 管理行为。迄今为止，对透析前CKD的人进行自我管理的研究有限， 尽管早期CKD可以说是限制疾病进展并预防并发症的最关键时机。 在慢性肾功能不全队列（CRIC）研究中，这项研究的总体目标是一项大型 diAysis ckd队列，包括：1）描述参与CKD自我管理行为的整体和通过 关键特征，2）探索具有CKD自我管理特定模式的个体的子组 参与，3）评估参与CKD自我管理行为的潜在预测指标，4） 调查CKD自我管理参与与长期和短期临床结果的关联。 通过这些初步分析，我们旨在了解CKD自我管理参与及其的见解 与诊断前CKD队列中的临床结果相关。我们预计这个项目将产生关键 洞悉与CKD自我管理参与相关的临床因素，并将产生新的 假设通过识别来提高CKD自我管理领域的未来研究 自我管理参与的障碍和面临不良结果风险的最高风险。 拟议的NRSA奖学金申请将为Schrauben博士提供深入的培训 在临床流行病学，生物统计学，健康行为和健康素养研究中，多方面的职业 具有不同背景的补充导师的发展，支持她产生高质量 数据，执行统计分析，解释发现并准备手稿以供出版。最终，博士 Schrauben将获得技能，使她能够成熟作为研究人员，并成功竞争K- 水平职业发展奖，以进一步了解自我管理在CKD中的作用并帮助告知 高风险组的有针对性干预措施。