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: 10557841
• 负责人: Megan Hosey
• 金额: $ 16.43万
• 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/10557841
• 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; Measures; Mechanical ventilation; Medical; Medicine; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; National Heart, Lung, and Blood Institute; Outcome; Outcome Measure; Pathway interactions; Patient Recruitments; Patient-Focused Outcomes; Patients; Pattern; Population; Psychologist; Publications; Qualitative Research; Quality of life; Randomized; Randomized, Controlled Trials; Recommendation; Recovery; Rehabilitation therapy; Reporting; Research; Research Personnel; Resources; Scientist; Sedation procedure; Self Efficacy; Self Management; Societies; Solid; Structure; Survivors; Telephone; Titrations; Training; Wakefulness; Writing; acceptability and feasibility; anxiety management; anxiety reduction; anxiety symptoms; avoidance behavior; awake; 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，越来越多的成年人患上急性呼吸衰竭(ARF)，需要机械治疗 重症监护病房(ICU)的通风。为了改善患者的预后，循证指南 建议滴定镇静剂，以便患者在ICU时保持清醒。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 干预措施是为焦虑症患者建立的、基于证据的一线治疗。然而，还有 急性肾功能衰竭患者自我管理干预的可行性和益处的证据有限 住院治疗。因此，这项K23建议寻求：1)对住院患者进行定性研究，以 在急性呼吸衰竭(SMARF)干预中完善现有的自我管理(目标1)和2)实施 ICU和病房改良SMARF干预与常规护理的试点随机对照试验(RCT) 确定其在降低焦虑方面的可行性、可接受性(主要结果；目标2a)和潜在疗效 出院时的症状和相关结果(目标2b)和3个月的随访(次级 结果；目标3)。 梅根·霍西博士，约翰·霍普金斯大学的执业临床心理学家和助理教授 医学院，有一个长期的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，研究早期干预措施，以减轻心理症状和改善长期 期末功能结局。通过这个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在定性研究方面的专业知识，2)深化 通过完成健康科学硕士(MHS)在以患者为中心的研究方面的知识和经验 临床研究和开展随机对照试验的学位，以及3)获得科学指导经验 出版和赠款写作。该奖项将产生初步数据和技能，为 一项成功的未来R级拨款和获得独立调查员地位的途径。这个奖项将建立 基于Hosey博士在ARF患者和她的自我管理干预方面的广泛临床专业知识 通过提供有针对性的教学训练从ARF中恢复的心理社会方面的研究背景 和世界级团队的指导研究经验，所有这些都发生在资源丰富的学术机构 环境。