LIFESTYLE REDESIGN FOR PRESSURE ULCER PREVENTION IN SCI

重新设计生活方式以预防 SCI 压疮

• 批准号: 7683734
• 负责人: FLORENCE A. CLARK
• 金额: $ 61.45万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7683734
• 关键词: Address; Adult; Attention; Behavior; California; Client; Collaborations; Communities; Complication; Cost Savings; Decubitus ulcer; Emotional; Health; Health Care Costs; Healthcare; Home visitation; Hospitalization; House Call; Incidence; Individual; Intervention; Investigation; Knowledge; Life; Life Style; Link; Manuals; Measures; Mediating; Medical; Modeling; Operative Surgical Procedures; Outcome; Participant; Performance; Persons; Phase; Population; Prevention; Preventive; Preventive Intervention; Process; Public Health; Quality of life; Randomized; Randomized Clinical Trials; Recording of previous events; Recruitment Activity; Rehabilitation Centers; Rehabilitation therapy; Relative (related person); Research; Research Personnel; Risk; Sampling; Savings; Self Efficacy; Series; Social support; Societies; Spinal cord injury; Staging; Telephone; Testing; Treatment Cost; Ulcer; Universities; Woman; base; behavior change; cost; cost effectiveness; efficacy trial; follow-up; high risk; improved; intervention effect; lifestyle intervention; member; men; prevent; public health relevance; standard care; successful intervention; therapy design

DESCRIPTION (provided by applicant): Advanced pressure ulcers are a common and medically serious complication of spinal cord injury (SCI) and are associated with extremely high treatment costs and reduced quality of life. However, preventive interventions that address this problem have received very little research attention. To address this gap, we will investigate the efficacy of a promising lifestyle intervention designed to prevent pressure ulcers among at-risk members of the SCI population. The resulting five-year study will involve collaboration between researchers from the University of Southern California (USC) and Rancho Los Amigos National Rehabilitation Center (RLANRC), who have developed the intervention based on the results of a qualitative investigation of lifestyle and ulcer risk among adults with SCI. The long-term objective of this project is to identify an intervention option that can enhance the health and life quality of the population of adults with SCI while simultaneously diminishing the heavy healthcare burden that results from the problem of SCI-related pressure ulcers. The specific aims of the proposed research are to: (a) conduct a randomized clinical trial of the intervention's ability to reduce the incidence of high grade (Stage 3 or 4) pressure ulcers in adults with SCI; (b) assess the cost-effectiveness and potential cost savings of the intervention; (c) examine the intervention's effects on participants' quality of life; and (d) model the process mechanisms that mediate the effects of the intervention. To accomplish these aims, 160 ethnically diverse men and women (including English and Spanish speakers) who are at least 6 months post-SCI and who have a history of at least one previous severe pressure ulcer will be recruited at a major rehabilitation facility and randomly assigned to either a 12- month lifestyle-based intervention condition or a standard care control condition. The intervention will consist of in-home visits and phone calls, with the intent to develop for each client a personalized plan for pressure ulcer prevention. Study participants will be followed for one year following the completion of the intervention phase of the trial. Outcome analyses will test whether the intervention reduces the incidence of new serious ulcers, reduces surgeries and other ulcer-linked medical treatment costs, and/or enhances quality of life. The project will benefit public health by increasing the physical and emotional wellness of a large sector of individuals who are at high risk for sickness and hospitalization due to the pressure ulcer problem. If successful, the intervention has the capacity to generate large financial savings and thereby help counteract society's rising healthcare costs. PUBLIC HEALTH RELEVANCE: Medically serious pressure ulcers are a common complication of spinal cord injury and are associated with extremely high treatment costs and reduced quality of life. In this study we will test a lifestyle intervention that promises to significantly reduce pressure ulcers in the population of adults with spinal cord injury.

描述（由申请人提供）：晚期压力溃疡是脊髓损伤（SCI）的常见和医学上严重的并发症，并且与极高的治疗成本和生活质量降低有关。但是，解决此问题的预防干预措施几乎没有得到研究的关注。为了解决这一差距，我们将调查有前途的生活方式干预措施的功效，旨在防止SCI人群的高危成员之间的压力溃疡。由此产生的五年研究将涉及南加州大学（USC）和洛斯·阿米戈斯国家康复中心（RLANRC）的研究人员之间的合作，他们根据SCI成人的生活方式和溃疡风险进行了定性研究的结果，他们根据对生活方式和溃疡风险进行了定性研究的结果。该项目的长期目标是确定一种干预措施，可以提高SCI成年人人群的健康和生活质量，同时减轻与SCI相关压力溃疡问题的严重医疗保健负担。拟议研究的具体目的是：（a）对干预措施降低高级（3或4期）SCI成人压疮的发生率的能力进行随机临床试验； （b）评估干预措施的成本效益和潜在的成本节省； （c）检查干预对参与者生活质量的影响； （d）建模介导干预效果的过程机制。为了实现这些目标，在SCI之后至少6个月且具有至少一个先前的严重压力溃疡的历史的160个种族多样化的男人和女人（包括英语和西班牙语者）将在主要的康复设施中招募，并随机分配给基于12个月的基于基于生活方式的干预措施或标准护理控制条件或标准护理控制状况。干预措施将包括在家访问和电话组成，目的是为每个客户制定一个个性化的预防压力溃疡计划。在审判的干预阶段完成后，将遵循研究参与者一年。结果分析将测试干预措施是否降低了新的严重溃疡的发生，减少手术和其他溃疡与溃疡相关的医疗费用和/或提高生活质量。由于压力性溃疡问题，该项目将通过增加处于疾病和住院高风险的个人的身体和情感健康来使公共卫生受益。如果成功，干预措施有能力产生大量的财务节省，从而有助于抵消社会的医疗保健成本上升。公共卫生相关性：医学上严重的压力溃疡是脊髓损伤的常见并发症，并且与极高的治疗成本和生活质量降低有关。在这项研究中，我们将测试一种生活方式干预措施，该干预措施有望大大减少脊髓损伤成年人的压力溃疡。