Improving Psychological Outcomes for Acute Respiratory Failure Survivors using a Self-Management Intervention

使用自我管理干预措施改善急性呼吸衰竭幸存者的心理结果

• 批准号: 10370615
• 负责人: Megan Hosey
• 金额: $ 15.8万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10370615
• 关键词: Acute respiratory failure; Address; Adult; American Psychological Association; Anxiety; Award; Bed rest; Chronic Disease; Clinical; Critical Care; Data; Delirium; Doctor of Philosophy; Dropout; Early Intervention; Enrollment; Environment; Evaluation; Evidence based intervention; Evidence based treatment; Feedback; Feeling; Foundations; Fright; Funding; Future; Goals; Grant; Guidelines; Health Sciences; Home; Hospitalization; Hospitals; Impairment; Intensive Care Units; Intervention; Interview; Knowledge; Measurement; Measures; Mechanical ventilation; Medical; Medicine; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; National Heart, Lung, and Blood Institute; Outcome; Outcomes Research; Pathway interactions; Patient Recruitments; Patient-Focused Outcomes; Patients; Pattern; Population; Psychologist; Publications; Qualitative Research; Quality of life; Randomized; Randomized Controlled Trials; Recovery; Rehabilitation therapy; Reporting; Research; Research Personnel; Resources; Scientist; Sedation procedure; Self Efficacy; Self Management; Societies; Solid; Structure; Survivors; Telephone; Training; Wakefulness; Writing; anxiety management; anxiety symptoms; avoidance behavior; awake; base; career; clinical investigation; clinical practice; clinically significant; cost; death anxiety; depressive symptoms; design; disabling symptom; evidence base; evidence based guidelines; experience; follow up assessment; follow-up; functional outcomes; improved; improved outcome; medical schools; mortality; novel; patient oriented; patient oriented research; primary outcome; professor; psychologic; psychological distress; psychological outcomes; psychological symptom; psychosocial; secondary outcome; sedative; side effect; skills; treatment as usual; usual care arm; ward

An increasing number of adults in the U.S. develop acute respiratory failure (ARF) requiring mechanical ventilation in an intensive care unit (ICU). To improve patient outcomes, evidence-based guidelines recommend titrating sedatives to allow for patient wakefulness while in the ICU. However, among awake ARF patients, anxiety can be a common and long-lasting problem. Outside of the ICU setting, self-management interventions are established, evidence-based, first-line treatments for patients with anxiety. However, there is limited evidence about the feasibility and benefit of self-management interventions for ARF patients during hospitalization. Hence, this K23 proposal seeks to: 1) conduct a qualitative study in hospitalized patients to refine an existing Self-Management in Acute Respiratory Failure (SMARF) intervention (Aim 1), and 2) conduct a pilot randomized controlled trial (RCT) of the refined SMARF intervention vs. usual care in the ICU and wards to establish its feasibility, acceptability (primary outcome; Aim 2a), and potential efficacy in reducing anxiety symptoms and associated outcomes at hospital discharge (Aim 2b) and at 3-month follow-up (secondary outcomes; Aim 3). Megan Hosey, PhD, a practicing clinical psychologist and Assistant Professor at the Johns Hopkins School of Medicine, has a long-term career goal of becoming an independent, patient-oriented researcher in acute respiratory failure, examining early interventions to reduce psychological symptoms and improve long- term functional outcomes. Through this K23 award, Dr. Hosey will achieve the following career goals: 1) gain expertise in qualitative research via didactic coursework and mentored practical experience, 2) deepen knowledge and experience in patient-oriented research by completing a Master of Health Science (MHS) degree in Clinical Investigation and conducting a pilot RCT, and 3) gain mentored experience with scientific publication and grant writing. This award will result in preliminary data and skills that will lay the foundation for a successful future R-level grant and pathway towards independent investigator status. This award will build upon Dr. Hosey’s extensive clinical expertise in self-management interventions for ARF patients and her research background in the psychosocial aspects of recovery from ARF via providing tailored didactic training and mentored research experience with a world-class team, all occurring in a resource-rich academic environment.

在美国，越来越多的成年人出现需要机械治疗的急性呼吸衰竭 (ARF) 重症监护病房 (ICU) 的通气。为了改善患者的治疗效果，基于证据的指南 建议滴定镇静剂，以使患者在 ICU 期间保持清醒。然而，在清醒的 ARF 中 对于患者来说，焦虑可能是一个常见且长期存在的问题。在 ICU 环境之外，自我管理 干预措施是针对焦虑症患者的既定、基于证据的一线治疗方法。然而，有 关于 ARF 患者自我管理干预措施的可行性和益处的证据有限 住院治疗。因此，这项 K23 提案旨在：1）对住院患者进行定性研究，以 完善现有的急性呼吸衰竭自我管理 (SMARF) 干预措施（目标 1）和 2） 一项针对 ICU 和病房中精细 SMARF 干预与常规护理的试点随机对照试验 (RCT) 确定其可行性、可接受性（主要结果；目标 2a）以及减少焦虑的潜在功效 出院时（目标 2b）和 3 个月随访（次要）时的症状和相关结果 结果；目标3）。 梅根·霍西 (Megan Hosey) 博士，约翰·霍普金斯大学临床心理学家兼助理教授 医学院的长期职业目标是成为一名独立的、以患者为中心的研究人员 急性呼吸衰竭，检查早期干预措施以减少心理症状并改善长期症状 术语功能结果。通过此次K23奖项，Hosey博士将实现以下职业目标：1）获得 通过教学课程和指导实践经验获得定性研究方面的专业知识，2）加深 通过完成健康科学硕士学位 (MHS) 获得以患者为导向的研究方面的知识和经验 临床研究学位并进行试点随机对照试验，3）获得科学指导经验 出版和资助写作。该奖项将产生初步数据和技能，为 未来成功的 R 级资助和获得独立研究者地位的途径。该奖项将打造 Hosey 博士在 ARF 患者自我管理干预方面拥有丰富的临床专业知识，她的 通过提供量身定制的教学培训，获得 ARF 康复的心理社会方面的研究背景 并与世界一流的团队一起指导研究经验，所有这些都发生在资源丰富的学术机构中 环境。