Suicide risk detection and mitigation in patients with head and neck cancer

头颈癌患者的自杀风险检测和缓解

基本信息

批准号：
10283716
负责人：
Nosayaba Osazuwa-Peters
金额：
$ 16.19万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10283716
关键词：
Accident and Emergency department Address Adjustment Disorders Adopted Alcohols Automobile Driving Cancer Etiology Cancer Patient Cancer Survivor Caring Cause of Death Cessation of life Chronic Disease Clinical Consolidated Framework for Implementation Research Data Depression screen Detection Diagnosis Distress Effectiveness Evaluation Feedback Feeling suicidal Future Goals Gold Head and Neck Cancer Head and neck structure Health Individual Intervention Interview Investigation Knowledge Link Literature Longitudinal Studies Malignant Neoplasms Measures Mental Depression Mentors Methods Modeling Morbidity - disease rate Nurse Practitioners Nurses Oncologist Oncology Outcome Patient Recruitments Patient risk Patients Persons Population Positioning Attribute Prevalence Prevention strategy Prospective cohort Provider Psychiatric epidemiology Public Health Questionnaires Reporting Research Research Design Research Methodology Research Personnel Risk Management Sampling Screening procedure Severities Site Spouses Substance abuse problem Suicide Suicide attempt Suicide prevention Survivors System Testing Time Training Triage United States Food and Drug Administration United States National Institutes of Health University Hospitals Use Effectiveness Work base cancer diagnosis career chronic pain clinical practice comorbidity design effectiveness evaluation effectiveness implementation study effectiveness testing evidence base follow-up head and neck cancer patient health care settings high risk ideation implementation facilitators implementation framework implementation science informant insight novel patient population patient screening patient subsets preventive intervention psychosocial public health relevance routine care routine screening screening suicidal suicidal behavior suicidal morbidity suicidal patient suicidal risk suicide model suicide mortality suicide rate tool

项目摘要

PROJECT SUMMARY/ABSTRACT The goal of this K01 proposal is to provide the candidate with formal training and mentoring in psychiatric epidemiology, psycho-oncology and implementation science; training needed to pursue an independent career in implementing interventions to detect and mitigate suicide risks among head and neck (HNC) cancer patients. Suicide is the 10th leading cause of death, and 1 person dies by suicide every 11 minutes in the US. Among individuals at higher risk of suicide are chronic disease sufferers, including cancer survivors. The suicide mortality rate for HNC patients is 63.4 per 100,000 person-years, which is four times more than the general US population. Clearly, suicide is an important public health crisis in the US and is considered a leading health indicator by the Healthy People initiative. Screening for suicidal ideation is an evidence-based suicide prevention and mitigation strategy. Several studies have demonstrated that it is feasible and effective to screen patients for suicidal ideation and behavior in various clinical settings, including general, non-psychiatric emergency room settings. The Food and Drug Administration (FDA) has endorsed the Columbia Suicide Severity Rating Scale (C-SSRS) as the tool of choice for screening for suicidal ideation and behavior. However, suicide screening interventions among HNC patients are lacking, in part due to the gaps in our understanding of the multilevel barriers associated with screening HNC patients for risks of suicide. To address this gap, the candidate will utilize the C-SSRS to characterize suicide risk among HNC patients, and test effectiveness and potential implementability of the C- SSRS as a routine suicide screening tool in HNC care. Using informant interviews with key stakeholders, candidate will identify patient, provider and other barriers that could underlie the suboptimal investigation of suicidal ideation among HNC patients in Aim 1. In Aim 2, candidate will administer the C-SSRS to a group of HNC patients, providing insights on suicidal ideation and severity among HNC patients in the US. In addition, a risk management/triage system will be developed to provide follow-up care when suicide risk is detected. Aim 3 will involve a mixed-method evaluation with a subset of patients who received the C-SSRS from Aim 2 to elicit feedback on the administration of the C-SSRS, and a debrief with providers to assess future implementability of the C-SSRS as routine part of HNC care. This research will have scientific impact by enhancing our enhancing our knowledge of the barriers to screening for suicide in the HNC setting. It will have significant clinical impact through the novel utilization of the C-SSRS in HNC care. Lessons learned will be adopted for future studies in HNC and across the cancer continuum. The training objective is to address the candidate’s scientific gaps in psychiatric epidemiology, psycho-oncology, qualitative/mixed methods research design, and implementation science. Completion of this proposal and training will position the candidate as a transdisciplinary, independent investigator in implementing interventions to decrease psychosocial morbidity in the HNC population.

项目摘要/摘要该K01提案的目的是为候选人提供精神病的正式培训和心理流行病学，心理肿瘤学和实施科学；从事独立职业所需的培训在实施干预措施以检测和减轻头颈部（HNC）癌症患者中的自杀风险。自杀是死亡的第十个主要原因，在美国，每11分钟自杀一次。之中自杀风险较高的个体是包括癌症存活在内的慢性疾病患者。自杀死亡率 HNC患者的比率为每100,000人年63.4，是美国普通人群的四倍。显然，自杀是美国重要的公共卫生危机，被认为是领先的健康指标健康的人倡议。筛选自杀想法是一种基于证据的自杀预防和缓解措施战略。几项研究表明，筛查患者的自杀想法是可行且有效的和在各种临床环境中的行为，包括一般，非精神急诊室环境。食物药物管理局（FDA）认可哥伦比亚自杀严重程度评级量表（C-SSRS）作为工具选择自杀念头和行为的选择。但是，HNC之间的自杀筛查干预措施缺乏患者，部分原因是我们理解与筛查HNC患者是否有自杀的风险。为了解决这一差距，候选人将使用C-SSRS 表征HNC患者的自杀风险，以及C-的测试有效性和潜在实施 SSR作为HNC Care中的常规自杀筛查工具。使用与主要利益相关者的线人访谈，候选人将确定患者，提供者和其他障碍，这些障碍可能是对 AIM 1中HNC患者的自杀想法。在AIM 2中，候选人将对一组C-SSR进行管理 HNC患者在美国HNC患者中提供有关自杀念头和严重程度的见解。另外，当检测到自杀风险时，将开发风险管理/分类系统以提供后续护理。目标3 将涉及混合方法评估与从AIM 2接收C-SSR的一部分患者有关C-SSRS管理的反馈，以及提供者的调试，以评估未来的实施 C-SSR作为HNC护理的常规部分。这项研究将通过增强我们的增强来产生科学影响我们对HNC环境中筛查自杀的障碍的了解。它将产生重大临床影响通过在HNC护理中的C-SSR的新颖利用。汲取的教训将被接受以后的研究 HNC和整个癌症都在继续。培训目标是解决候选人的科学差距精神病流行病学，心理肿瘤学，定性/混合方法研究设计和实施科学。该提案和培训的完成将使候选人成为跨学科的独立研究人员实施干预措施以减少HNC人群的心理社会发病率。