Risk of Adverse Outcomes after Spinal Cord Injury: A Longitudinal Study

脊髓损伤后不良后果的风险：一项纵向研究

• 批准号: 7743372
• 负责人: JAMES S KRAUSE
• 金额: $ 41.46万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-01 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7743372
• 关键词: Accounting; Address; Adult; Behavior; Behavioral; Behavioral Model; Categories; Chronic; Classification; Collection; Cost-Benefit Analysis; Data; Development; Dimensions; Environmental Risk Factor; Equation; Factor Analysis; Fatigue; Frequencies; Guide prevention; Health; Health behavior; Individual; Individual Differences; Injury; Intervention; Lead; Linear Models; Longitudinal Studies; Measures; Mediating; Mental Depression; Mental Health; Modeling; Morbidity - disease rate; Outcome; Outcome Measure; Pain; Participant; Patient Self-Report; Personal Satisfaction; Prevention strategy; Proxy; Risk; Risk Factors; Sampling; Spinal; Spinal cord injury; Structural Models; Structure; Testing; Time; Variant; adverse outcome; base; data modeling; depressive symptoms; follow-up; global health; high risk; mortality; physical conditioning; predictive modeling; prevent; psychologic; risk selection; secondary outcome; social; Accounting; Address; Adult; Behavior; Behavioral; Behavioral Model; Categories; Chronic; Classification; Collection; Cost-Benefit Analysis; Data; Development; Dimensions; Environmental Risk Factor; Equation; Factor Analysis; Fatigue; Frequencies; Guide prevention; Health; Health behavior; Individual; Individual Differences; Injury; Intervention; Lead; Linear Models; Longitudinal Studies; Measures; Mediating; Mental Depression; Mental Health; Modeling; Morbidity - disease rate; Outcome; Outcome Measure; Pain; Participant; Patient Self-Report; Personal Satisfaction; Prevention strategy; Proxy; Risk; Risk Factors; Sampling; Spinal; Spinal cord injury; Structural Models; Structure; Testing; Time; Variant; adverse outcome; base; data modeling; depressive symptoms; follow-up; global health; high risk; mortality; physical conditioning; predictive modeling; prevent; psychologic; risk selection; secondary outcome; social

Spinal cord injury (SCI) heightens risk for adverse health outcomes and secondary conditions, including poor general health, the development of chronic health conditions such as pain and fatigue, and poor Dsychosocial adaptation including an elevated risk for depression. Although there are substantial individual differences in likelihood of developing these conditions, the risk factors that account for the variations are not fully understood, nor have they been systematically investigated. The purpose of the proposed 10-year longitudinal study is to identify differential risk for 3 sets of adverse health outcomes using two empirical models to guide selection of risk variables. The first general risk model highlights conceptual categories of risk variables from multiple levels including behavioral, psycho-social/environmental, and biographic/injury factors in predicting morbidity and mortality. The second bi-dimensional behavioral model assesses the risk of poor health outcomes along independent risk and protective behavioral dimensions. Preliminary data was collected 10 years prior to collection of the proposed follow-up outcome data from 1,391 adult participants with traumatic SCI of at least 1-year duration. These participants will complete a self-report battery of measures as will a new sample of over 1,000 cases. Measures will include reassessment of risk factors and a detailed assessment of health outcomes. General linear model will be used to explore the cross-sectional data as a prelude to confirmatory analyses of the longitudinal data using structural equation modeling (SEM). The SEM will include confirmatory factor analysis to test the clarity of our conceptual categories and independence of our outcome measures, longitudinal change modeling to test the direct effects of time 1 predictors on time 2 outcomes, multiple groups modeling to evaluate hypotheses from our bi-dimensional model, and incomplete data modeling to identify and compensate for selective attrition. Results of the study will enhance our understanding of the natural course of health decline and development of secondary conditions, lead to refined predictive models, and will serve as a basis for developing prevention strategies to limit and/or prevent these conditions among people with SCI.

脊髓损伤（SCI）增加了不良健康结果和次要疾病的风险，包括差 一般健康，疼痛和疲劳等慢性健康状况的发展以及差 心理社会适应，包括抑郁症的风险升高。虽然有很大的个人 开发这些条件的可能性差异，解释变化的风险因素不是 完全理解，也没有系统地研究它们。拟议的10年的目的 纵向研究是使用两种经验来确定3组不良健康结果的差异风险 指导选择风险变量的模型。第一个一般风险模型突出显示了的概念类别 来自多个级别的风险变量，包括行为，心理社会/环境和传记/伤害 预测发病率和死亡率的因素。第二个双维行为模型评估风险 独立风险和保护性行为方面的健康状况不佳。初步数据是 收集了1,391名成年参与者的拟议后续结果数据之前的10年 创伤性SCI至少为1年。这些参与者将完成一个自我报告的电池 措施与1,000多个案例的新样本一样。措施将包括重新评估风险因素和 对健康结果的详细评估。一般线性模型将用于探索横截面 数据是使用结构方程建模（SEM）对纵向数据进行确认分析的序幕。 SEM将包括确认性因素分析，以测试我们的概念类别的清晰度和 我们的结果度量的独立性，纵向变化建模以测试时间1的直接影响 时间2的预测因素，多个组建模以评估我们的双维假设 模型和不完整的数据建模，以识别和补偿选择性损耗。研究结果 将增强我们对次要健康衰落和发展的自然发展的理解 条件，导致精致的预测模型，并将作为制定预防策略的基础 限制和/或防止SCI患者之间的这些条件。