SHARED DECISION-MAKING AND INAPPROPRIATE ANTIBIOTIC USE

共同决策和不当抗生素使用

• 批准号: 6531460
• 负责人: ELIZABETH D. COX
• 金额: $ 10.87万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6531460
• 关键词: antibiotics; behavioral /social science research tag; clinical research; communication; data collection methodology /evaluation; decision making; health care quality; health services research tag; human subject; patient care management; patient care personnel relations; pediatrics; physicians; questionnaires; respiratory infections; sign /symptom; videotape /videodisc

This proposal requests support for a Mentored Clinical Scientist Award (K08) for Dr. Elizabeth Cox to become an independent researcher in the field of doctor-patient communication, with a focus on the use of shared decision-making to improve quality of care for children. This award will facilitate Dr. Cox's acquisition of advanced research competencies in the science of interpersonal communication in clinical settings. The proposed training program will include completion of a Ph.D. in Population Health, training in analysis of communication during medical interactions, as well as both individual and group mentoring. The University of Wisconsin offers an ideal environment for the proposed work because it provides access to renowned researchers in discourse analysis (Dr. Mary Anne Fitzpatrick), physician satisfaction (Dr. Mark Linzer) and mentoring of women researchers (Drs. Molly Carnes). Dr. Debra Roter (The Johns Hopkins University) will provide mentoring in the analysis of physician-patient communication. Dr. Cox also has strong support from the Department of Population Health Science and the Center for Women's Health Research, Dr. Cox will participate in the UW Clinical Investigator Preparatory Pathway (NIH K30), which assures competency in core areas of statistics, study design, research ethics, management/leadership, and scientific writing. During the period of this training grant, Dr. Cox will develop and validate an instrument to measure shared decision-making in pediatric primary care. This instrument will then be used in a cross-sectional study to examine the relationship of shared decision-making to quality of care outcomes for children's upper respiratory infection. The candidate hypothesizes that shared decision-making in acute primary care visits for upper respiratory infection will decrease inappropriate antibiotic prescribing, while providing satisfaction for both the parent and patient. The proposed research brings the strengths of a multi-disciplinary approach to a common clinical problem in the care of children. Shared decision-making has wide applicability to a variety of acute and chronic healthcare problems. If proven effective, the use of shared decision- making in this clinical setting will result in decreased anti-microbial resistance, decreased adverse events, and decreased cost of care, while preserving visit satisfaction.

该提案要求支持为伊丽莎白考克斯博士颁发指导临床科学家奖（K 08），使其成为医患沟通领域的独立研究人员，重点是利用共同决策提高儿童护理质量。该奖项将促进博士考克斯的收购先进的研究能力，在科学的人际沟通在临床设置。拟议的培训计划将包括完成博士学位。在人口健康方面，在医疗互动过程中进行沟通分析的培训，以及个人和团体的指导。威斯康星州的大学为拟议的工作提供了一个理想的环境，因为它提供了访问著名的研究人员在话语分析（博士玛丽安妮菲茨帕特里克），医生满意度（博士马克林泽）和指导的妇女研究人员（博士莫莉卡恩斯）。Debra Roter博士（约翰霍普金斯大学）将提供医患沟通分析方面的指导。考克斯博士还得到了人口健康科学系和妇女健康研究中心的大力支持，考克斯博士将参加华盛顿大学临床研究者预备课程（NIH K30），该课程确保了统计学、研究设计、研究伦理、管理/领导和科学写作等核心领域的能力。在此期间的培训补助金，博士考克斯将开发和验证一种工具，以衡量在儿科初级保健的共同决策。然后，该工具将被用于一项横断面研究，以检查儿童上呼吸道感染的护理结果的质量的共同决策的关系。候选人假设，在上呼吸道感染的急性初级保健就诊中共同决策将减少不适当的抗生素处方，同时为父母和患者提供满意度。拟议中的研究带来了一个多学科的方法，在照顾儿童的一个共同的临床问题的优势。共同决策对各种急性和慢性医疗保健问题具有广泛的适用性。如果证明有效，在这种临床环境中使用共同决策将导致抗菌药物耐药性降低、不良事件减少和护理成本降低，同时保持访视满意度。