The Social Environment, Psychological Distress, and Clinical Outcomes in COPD

COPD 的社会环境、心理困扰和临床结果

• 批准号: 7656857
• 负责人: Kristen E. Holm
• 金额: $ 14.05万
• 依托单位: NATIONAL JEWISH HEALTH
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-11 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7656857
• 关键词: Address; Affect; Anxiety; Behavioral; Catchment Area; Cause of Death; Characteristics; Chronic; Chronic Disease; Chronic Obstructive Airway Disease; Clinical; Communities; Couples; Data; Data Analyses; Deterioration; Development; Development Plans; Dyspnea; Educational Curriculum; Epidemiology; Exercise; Extended Family; Family; Family Relationship; Genetic; Goals; Health; High Prevalence; Individual; Intervention; Interview; Laboratories; Life; Link; Measures; Mediating; Mental Health; Mentors; Methods; Modeling; National Research Service Awards; Outcome; Participant; Patient Self-Report; Patients; Population; Public Health; Research; Research Personnel; Research Training; Resources; Rheumatoid Arthritis; Risk Factors; Sampling; Scientist; Social Environment; Social support; Socioeconomic Status; Spouses; Stroke; Structure; Testing; Time; Training; United States; abstracting; base; career; career development; depression; depressive symptoms; health related quality of life; improved; malignant breast neoplasm; mortality; neighborhood safety; novel; population based; programs; prospective; psychological distress; psychosocial; skills; social

DESCRIPTION (provided by applicant): The applicant is a family scientist who plans to have a research career developing interventions that address social and behavioral risk factors for adverse outcomes in chronic obstructive pulmonary disease (COPD). The proposed career development plan will provide mentoring and a structured didactic curriculum in public health that culminates in the applicant earning a Master's in Public Health. Advanced training in public health is essential to expanding the range of social factors that the applicant can assess and ultimately address in clinical interventions. Training goals include developing mastery in assessing aspects of the social environment beyond the family, extending the applicant's skills in methods of data analysis, and understanding psychosocial implications of having an identified genetic subtype of COPD. The aim of the proposed research is to test key paths in a model linking the social environment, psychological distress, and clinical outcomes among people with COPD. The applicant will comprehensively measure important aspects of the social environment, psychological distress, and clinical outcomes through self-report, clinical interview, and laboratory-based assessments. Data will be collected at three time points, each 12 months apart. Three hypotheses will be tested: 1) unsupportive family relationships, low social support, and lack of community resources will predict an increase in psychological distress; 2) the characteristics of the social environment described in Hypothesis 1 will predict deterioration in clinical outcomes (e.g., greater reduction in exercise capacity); and 3) high psychological distress will predict deterioration in clinical outcomes and mediate the effect of the social environment on clinical outcomes. The proposed research has direct relevance to public health. As the fourth leading cause of death in the United States, COPD is a major public health problem. The proposed research will provide data that are vitally important to the development of psychosocial interventions for people with COPD. The most comprehensive interventions can be developed after research establishes which aspects of the social environment are most crucial in affecting psychological distress and clinical outcomes in COPD. The training and research described in this proposal will provide the applicant with the skills to become an independent researcher focusing on the development of novel psychosocial interventions to improve clinical outcomes for people with COPD. (End of Abstract)

描述（由申请人提供）：申请人是一名家庭科学家，计划从事研究职业，开发干预措施，解决慢性阻塞性肺病（COPD）不良后果的社会和行为风险因素。拟议的职业发展计划将提供公共卫生方面的指导和结构化教学课程，最终使申请人获得公共卫生硕士学位。公共卫生方面的高级培训对于扩大申请人可以评估并最终在临床干预中解决的社会因素的范围至关重要。培训目标包括掌握评估家庭以外的社会环境的各个方面，扩展申请人的数据分析方法技能，以及了解已确定的慢性阻塞性肺病遗传亚型的心理社会影响。拟议研究的目的是测试模型中将社会环境、心理困扰和慢性阻塞性肺病患者临床结果联系起来的关键路径。申请人将通过自我报告、临床访谈和实验室评估来综合衡量社会环境、心理困扰和临床结果的重要方面。数据将在三个时间点收集，每个时间点相隔 12 个月。将检验三个假设：1）不支持的家庭关系、低社会支持和缺乏社区资源将预示心理困扰的增加； 2）假设1中描述的社会环境特征将预测临床结果的恶化（例如运动能力的更大程度下降）； 3）高度的心理困扰将预测临床结果的恶化并介导社会环境对临床结果的影响。拟议的研究与公共卫生直接相关。作为美国第四大死因，慢性阻塞性肺病是一个重大的公共卫生问题。拟议的研究将为慢性阻塞性肺病患者的心理社会干预措施的发展提供至关重要的数据。在研究确定社会环境的哪些方面对影响慢性阻塞性肺病的心理困扰和临床结果最关键后，可以制定最全面的干预措施。本提案中描述的培训和研究将为申请人提供成为独立研究人员的技能，专注于开发新型社会心理干预措施，以改善慢性阻塞性肺病患者的临床结果。 （摘要完）