Piloting an mHealth-delivered Mindfulness Therapy with Patients with Serious Illness and their Caregivers to Alleviate Symptoms of Anxiety

为重病患者及其护理人员试行移动医疗提供的正念疗法，以减轻焦虑症状

• 批准号: 10336750
• 负责人: Elissa K Kozlov
• 金额: $ 24.3万
• 依托单位: RUTGERS BIOMEDICAL/HEALTH SCIENCES-RBHS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10336750
• 关键词: Academy; Address; Adult; Aging; Anxiety; Appointment; Area; Award; Behavior Therapy; Behavioral; Benchmarking; Caregivers; Clinic; Clinical; Clinical Trials; Data; Data Analyses; Development Plans; Dissemination and Implementation; Distress; Dose; Dyspnea; Elderly; Face; Family; Family Caregiver; Fatigue; Future; Geriatrics; Goals; Health; Health Personnel; Health Policy; Health Resources; Healthcare; Healthcare Systems; Hospitals; Individual; Institutes; Intervention; Interview; Israel; Lead; Leadership; Logistics; Manuscripts; Medicine; Meditation; Mental Depression; Mental Health; Mentors; Mentorship; Methodology; Mindfulness Training; Modeling; New Jersey; Outcome; Pain; Palliative Care; Participant; Patients; Pattern; Peer Review; Polypharmacy; Population; Positioning Attribute; Post-Traumatic Stress Disorders; Primary Health Care; Protocols documentation; Provider; Psyche structure; Psychiatrist; Psychologist; Psychotherapy; Public Health; Public Health Schools; Quality of life; Randomized; Reporting; Research; Research Personnel; Research Training; Risk; Sampling; Schedule; Stress; Symptoms; Targeted Research; Testing; Therapeutic Intervention; Time; Training; Transportation; United States Department of Veterans Affairs; United States National Institutes of Health; Universities; Wood material; Work; acceptability and feasibility; anxiety management; anxiety symptoms; base; burnout; career; career development; caregiving; coping; evidence base; experience; geriatric mental health; group intervention; high risk; implementation science; improved; innovation; mHealth; member; mindfulness; mortality; novel; psychoeducation; psychologic; recruit; reduce symptoms; response; satisfaction; skills; stress management; symptom management; usability

Project Abstract Candidate: Elissa Kozlov’s career goal is to be an independent investigator dedicated to improving the mental health outcomes of older adults with serious illness and their families, while establishing herself as a leader in the field of geriatric mental health care and palliative care. She is a licensed clinical psychologist with expertise in geriatrics and palliative care, and she has authored 25 peer-reviewed (15 first-authored) manuscripts. Research: Up to 70% of adults with serious illness have symptoms of anxiety. Undiagnosed and undertreated anxiety contributes to higher risk of pain, depression, fatigue, dyspnea, and polypharmacy. Patients with high symptom burden and anxiety heavily impact family caregivers, which nearly 8 million older adults in the U.S. rely on for assistance. Decades of research reveal the negative effects of caregiving on caregivers, (e.g., high levels of stress, depression, and anxiety). Furthermore, there is a mutuality of distress in the caregiver/patient dyad — when patients suffer psychologically, the caregiver suffers too. Unfortunately, older adults and their caregivers have limited access to mental health resources because of shortages of mental health providers as well as logistical issues including time constraints, transportation, and scheduling. The objective of this study is to evaluate the feasibility, acceptability, and preliminary efficacy of Mindfulness Coach, an mHealth Mindfulness Therapy intervention developed by the Veterans Affairs, to reduce anxiety in older adults with serious illness and their family caregivers. An efficacious and scalable behavioral intervention that mitigates symptoms of patient and caregiver anxiety has the potential to reduce distress and enhance coping in the patient–caregiver dyad without contributing to polypharmacy or burdensome appointments. Research is urgently needed to evaluate the feasibility, acceptability, and preliminary efficacy of dyadic mHealth mindfulness therapy in older adults with serious illness and their caregivers. Career Development: Dr. Kozlov has assembled an interdisciplinary team of mentors (Primary: Drs. Dong & Reid, Mentorship Committee [Israel, Duberstein, and Hoover]) with expertise in geriatrics, mental health, dissemination and implementation sciences, caregiving, and mHealth. Her career development plan integrates coursework, seminars, and mentorship in the following areas: (1) Skills in mHealth interventions, data analysis and clinical trials, 2) Dyadic interventions and analyses in geriatrics and palliative care, 3) Dissemination and Implementation sciences (D&I), and 4) Leadership and grantsmanship. With support from the Rutgers University Institute for Health, Health Policy and Aging Research, The School of Public Health and RWJ Barnabas Healthcare System, Dr. Kozlov is positioned to lead geriatric mental health initiatives that are supported by rigorous, programmatic research. The proposed research, training, and mentorship plan will provide Dr. Kozlov with the data, skills and experience needed to become a leader in implementing and delivering innovative mental health care to older adults with serious illness and their caregivers.

项目摘要 候选人：伊莉莎·科兹洛夫的职业目标是成为一名致力于改善心理健康的独立调查员 患有严重疾病的老年人及其家人的健康状况，同时确立自己在 老年精神卫生保健和姑息治疗领域。她是一名有执照的临床心理学家，具有专业知识。 在老年病和姑息治疗方面，她撰写了25篇同行评议的手稿(其中15篇是第一作者)。 研究：高达70%患有严重疾病的成年人有焦虑症状未得到诊断和治疗不足 焦虑会增加疼痛、抑郁、疲劳、呼吸困难和服用多药的风险。患有高血压病患者 症状负担和焦虑严重影响了家庭照顾者，美国有近800万老年人。 依靠别人的帮助。几十年的研究揭示了照顾对照顾者的负面影响(例如，高 压力、抑郁和焦虑的程度)。此外，在照顾者/患者中存在痛苦的相互关系 当病人遭受心理上的痛苦时，照顾者也会遭受痛苦。不幸的是，老年人和他们的 照顾者获得精神卫生资源的机会有限，因为精神卫生提供者短缺，因为 以及包括时间限制、运输和日程安排在内的后勤问题。这项研究的目的是 评价正念教练的可行性、可接受性和初步疗效 由退伍军人事务部开发的正念疗法干预，以减少患有 严重疾病及其家庭照顾者。一种有效且可扩展的行为干预，可缓解 患者和照顾者焦虑的症状有可能减轻痛苦并提高应对能力 患者-照顾者的双重身份，而不会导致多药或繁琐的预约。研究是 迫切需要评估二元mHealth的可行性、可接受性和初步疗效 患有严重疾病的老年人及其照顾者的正念疗法。 职业发展：科兹洛夫博士组建了一个跨学科的导师团队(主要成员：董博士和 里德，导师委员会[以色列，杜伯斯坦和胡佛])，在老年病学，精神健康， 传播和实施科学、护理和移动健康。她的职业发展计划包括 以下领域的课程、研讨会和指导：(1)移动健康干预、数据分析方面的技能 和临床试验，2)老年病和姑息治疗中的二元干预和分析，3)传播和 实施科学(D&I)，以及4)领导力和资质。在罗格斯大学的支持下 大学健康、健康政策和老龄化研究所，公共卫生学院和RWJ Barnabas Healthcare System，科兹洛夫博士将领导老年人心理健康计划 得到了严谨的程序性研究的支持。拟议的研究、培训和指导计划将 为科兹洛夫博士提供所需的数据、技能和经验，使其成为实施和 为患有严重疾病的老年人及其照顾者提供创新的精神卫生保健。