Symptom Biology After Heart Failure Hospitalization

心力衰竭住院后的症状生物学

• 批准号: 10474609
• 负责人: Jonathan Patrick Auld
• 金额: $ 15.95万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-24 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10474609
• 关键词: Address; Admission activity; Adult; Affect; Age-Years; Anxiety; Area; Behavioral; Biological; Biological Markers; Biology; Cardiovascular Diseases; Clinic Visits; Clinical Data; Clinical Management; Collection; Congestive; Congestive Heart Failure; Data; Devices; Distress; Dyspnea; Early Intervention; Emergency department visit; Emergent care; Fatigue; Fibrosis; Functional disorder; Galectin 3; Goals; Growth; Health; Heart failure; Hospitalization; Hospitals; Implant; Inflammation; Interleukin-6; Intervention; K-Series Research Career Programs; Knowledge; Lead; Linear Models; Liquid substance; Longitudinal prospective study; Measurement; Mental Depression; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentorship; Mission; Modeling; Monitor; Myocardial; National Institute of Nursing Research; Nurses; Outcome; Pain; Pathology; Patient Self-Report; Patients; Pattern; Perception; Persons; Pharmaceutical Preparations; Physiological; Physiology; Postdoctoral Fellow; Procedures; Process; Publishing; Pulmonary artery structure; Quality of life; Reporting; Research; Research Project Grants; Research Training; School Nursing; Series; Sleep; Symptoms; System; TNF gene; Telephone; Time; Training; Training Activity; United States; Universities; Washington; biobehavior; care seeking; career development; clinically relevant; community setting; cost effective; design; experience; health care service utilization; health related quality of life; hospital readmission; implantable device; improved; insight; minimally invasive; mortality; muscle stress; novel; physical symptom; prevent; pro-brain natriuretic peptide (1-76); psychologic; psychological symptom; pulmonary arterial pressure; real time monitoring; remote monitoring; sensor; statistics; symptom management; symptom science; technology development

PROJECT SUMMARY The purpose of this Mentored Patient-Oriented Research Career Development Award (K23) application is to provide additional research training for Dr. Jonathan Auld, a post-doctoral fellow at the University of Washington School of Nursing. The long-term goals of the applicant are to independently lead an interdisciplinary team in biobehavioral research and to design R-series studies that guide tailored HF symptom management interventions using biological, behavioral and clinical data. Heart failure is a growing cardiovascular disorder that is characterize by high symptom burden, poor quality of life and high healthcare utilization. In addition, patients often struggle to identify and manage symptoms. A better understanding of how symptoms change after patients are discharged and the biological underpinnings of HF symptoms will provide needed information to address symptom burden earlier and to tailor symptom management intervention to improve quality of life and healthcare utilization. This career development award will support the applicant’s training and research goals through the provision of mentorship, coursework, and other training activities directly relevant to the content areas of advanced training in collection, measurement and analysis of HF biomarkers, symptom management interventions for people with chronic HF, the use of novel remote monitoring technology, and career development. The research project proposed in this application will examine how and when HF symptoms change after hospitalization. The applicant proposes a prospective longitudinal study (n=60) of adults with advance HF (NYHA III) after discharge from a HF hospitalization. Importantly, we will use novel data from CardioMEMS devices to better understand HF symptom biology. Specifically, this study aims to: 1) characterize and compare patterns of change in physical and psychological symptoms (dyspnea, fatigue, pain, depression and anxiety) biomarkers (IL-6, TNFα, NT-proBNP, sST2 and Galectin-3) and health-related quality of life over 6 months (discharge, 1 month, 3 months, 6 months) in patients with CardioMEMS and without CardioMEMS, 2) characterize and compare healthcare utilization over 6 months (medication changes, nurse phone contacts, urgent clinic visits, emergency room visits, re-hospitalizations, and mortality) in the CardioMEMS and non-CardioMEMS groups, and 3) quantify the association between CardioMEMS pulmonary artery pressure data, HF biomarkers, physical and psychological symptoms and HRQOL over 6 months. Descriptive statistics, latent growth curve modeling, parallel process growth curve modeling, and multivariate generalized linear modeling will be used to compare and characterize HF symptom trajectories, biomarker trajectories, and predictors of healthcare utilization over 6 months after discharge. Both the short and long-term goals of this Career Development Award align with the strategic mission of The National Institute of Nursing Research to understand the biological mechanisms of HF symptoms.

项目摘要 这个指导的以病人为导向的研究职业发展奖（K23）应用程序的目的 是为乔纳森·奥尔德博士提供额外的研究培训，他是牛津大学的博士后研究员。 华盛顿护理学院。申请人的长期目标是独立领导一个 生物行为研究的跨学科团队，并设计指导定制HF症状的R系列研究 利用生物、行为和临床数据进行管理干预。心力衰竭是一种日益严重的 以高症状负担、低生活质量和高保健为特征心血管疾病 利用率此外，患者往往难以识别和管理症状。更好地了解如何 患者出院后症状发生变化，HF症状的生物学基础将提供 所需的信息，以解决症状负担较早，并定制症状管理干预， 提高生活质量和保健利用率。 该职业发展奖将通过以下方式支持申请人的培训和研究目标： 提供指导、课程和其他与以下内容领域直接相关的培训活动： 在收集、测量和分析HF生物标志物、症状管理方面的高级培训 慢性HF患者的干预措施，新型远程监测技术的使用， 发展本申请中提出的研究项目将研究HF症状如何以及何时出现 住院后的变化。申请人提出了一项对患有以下疾病的成年人进行的前瞻性纵向研究（n=60）： HF住院出院后的晚期HF（NYHA III级）。重要的是，我们将使用来自 MEMS器件，以更好地了解HF症状生物学。具体而言，本研究旨在：1） 表征和比较生理和心理症状（呼吸困难，疲劳，疼痛， 抑郁和焦虑）生物标志物（IL-6、TNFα、NT-proBNP、sST 2和Galectin-3）和健康相关质量 在植入MEMS和未植入MEMS的患者中，超过6个月（出院、1个月、3个月、6个月） MEMS，2）表征和比较6个月内的医疗保健利用（药物变化，护士 电话联系、紧急门诊、急诊室就诊、再住院和死亡率）， 肺微机电系统和非肺微机电系统组，以及3）量化肺微机电系统之间的关联 6个月内的动脉压数据、HF生物标志物、身体和心理症状以及HRQOL。 描述性统计、潜在增长曲线建模、并行过程增长曲线建模和多变量 广义线性模型将用于比较和表征HF症状轨迹、生物标志物 轨迹和出院后6个月内医疗保健利用的预测因素。无论是短期还是长期 该职业发展奖的目标与国家护理研究所的战略使命一致 研究以了解HF症状的生物学机制。