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

在美国，越来越多的成年人出现急性呼吸衰竭（ARF），需要机械通气

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.