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Medical - Medical (general) | | English term or phrase: Brenner's proximal-distal continuum | | Qualitative focus group with 140 healthcare consumers and tow internet-based surveys of adults with chronic disease,comprising a total 1772 respondents, who were self-reported medication adhereers, non-persisters, and non-fulfillers. Psychometoric tests were performed on 150 items assessing 14 patient beliefs and skills hypothesized to be related to medication non-adherence along a proximal-distal continuum. Psychometoric tests included known-group discriminant validity at the scale and item level. |
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| | Japanese translation:see notes | Explanation:
referenceをご覧になったら分かるかと思います。
Brenner MH（ブレナー博士）という方が、proximal-distal continuumを提唱していて、医療技術評価（研究）での、医療効果指標（またはアウトカム指標）の選択にこのcontinuum（連続体）が有効であるとしています。
彼のいう'proximal'outcomeとは、 症状、疾患に特異的なアウトカム（signs and symptoms, disease-specific outcomes）であり、'proximal outcomes are those ((clinical indicators of disease that are influenced most directly and powerfully ))by an effective intervention'としており、一方 'distal' outcome とは、role functioning、 life satisfaction、general well-being等、’more removed from the illness per se and are usually the product of a multitude of nonillness or “external”factors; as such, distal outcomes ((tend to be influenced less directly and less powerfully)) by even very effective health inverventions’としています。あるいは、'influenced more heavily by external (i.e., nontreatment) factors’としています。
そういう観点からproximal-distalを使っているようです(つまり、proximal≒directly influenced, distal ≒indirectly influenced)。
人によっては、proximalを「近位」「近接した」（アウトカム）と訳し、distralを「遠位」、「遠隔の」(アウトカム）と訳す方もいらっしゃいます。
訳として、Brenner氏（or博士）のproximal－distal（アウトカム）のcontinuum（連続体）と訳すかと思います。
proximal-distal：
http://jco.ascopubs.org/content/21/9_suppl/82.full.pdf
http://www.jstor.org/pss/3766632
continuum:
http://oxforddictionaries.com/definition/continuum?view=uk
Finally, it demonstrates several ways in which the placement of a specific health outcome measure in the proximal-distal continuum determines the overall statistical model of treatment and nontreatment variables.
http://www.ncbi.nlm.nih.gov/pubmed/7723452
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Note added at 2 days1 hr (2011-12-21 08:34:46 GMT)
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「proximal-distalアウトカム指標のcontinuum（連続体）」。
proximal-distalは、英語のままで良いかと思いますが、あえて訳すなら上記の日本語を使えば良いと思います。 |
| Selected response from:
  Mami Yamaguchi
| Grading comment 丁寧な解説ありがとうございました。助かりました。
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