Building Bridges to Hospice and Rural Appalachia

架起通往临终关怀中心和阿巴拉契亚乡村的桥梁

• 批准号: 7296119
• 负责人: Kenneth L. Kirsh
• 金额: $ 18.63万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-18 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7296119
• 关键词: Address; Appalachian Region; Applied Research; Area; Attention; Attitude; Awareness; Cancer Patient; Caring; Clinical Research; Collaborations; Communities; Community Participation; Consent; Data; Data Collection; Dedications; Disease; Evidence based intervention; Family; Focus Groups; Fright; Future; Goals; Grant; Health Personnel; Home environment; Hospice Care; Institutes; Intervention; Interview; Job Satisfaction; Kentucky; Knowledge; Leadership; Left; Measures; National Cancer Institute; National Institute for Occupational Safety and Health; Needs Assessment; Nurses; Nursing Research; Occupational; Opioid; Opioid Analgesics; Outcome; Pain; Pain management; Palliative Care; Patients; Pharmaceutical Preparations; Pilot Projects; Poa plant; Policies; Population; Process; Protocols documentation; Provider; Purpose; Reporting; Research; Research Ethics Committees; Research Infrastructure; Research Personnel; Risk; Rural; Rural Community; Rural Population; Sampling; Self Efficacy; Series; Services; Social Workers; State Interests; Surveys; Time; Universities; Workplace; base; chronic pain; community based participatory research; community organizations; cost effective; demographics; design; end of life; end of life care; forging; health disparity; hospice environment; instrument; interest; knowledge base; medically underserved; novel; outreach; point of care; prescription document; prescription drug abuse; prescription procedure; programs; research study; social

DESCRIPTION (provided by applicant): Palliative care, and specifically the management of pain issues, is an important and understudied issue in rural Appalachian Kentucky. Despite attempts to increase awareness on this issue, pain continues to be under-treated for chronic pain patients, including those with advanced disease and at end-of-life. This will only worsen as fears grow concerning prescription medication abuse and diversion. The application is designed to create a fully functioning community-based participatory research (CBPR) entity between the University of Kentucky (UK) and Hospice of the Bluegrass (HOB). One major outcome of this relationship is to conduct a formal needs-based assessment of frontline care workers (i.e., nurses, CNAs, social workers) who have to manage pain issues in a rural population noted for issues with prescription drug abuse and diversion. Data will be used for the purpose of identifying barriers to effective treatment and to gather initial data for a future interventional study. The needs assessment will be conducted through focus groups, key informant interviews, and assessment of frontline care workers at HOB. Specific attention will be paid to deficits in the knowledge base of providers regarding the appropriate use of opioid analgesics. To meet this end, assessment instruments will include worker demographics, a survey of their knowledge base and attitudes about pain management, a job satisfaction survey, and a measure of general self-efficacy. An additional survey on opioid knowledge and fear of use, along with a case vignette, will be developed to further round out the assessment package. As a final step, the study will conclude the needs-based assessment by conducting an agency wide survey at HOB to target future areas for applied research that address the application of clinical research needs pertinent to HOB and their patient population.

描述（由申请人提供）：姑息治疗，特别是疼痛问题的管理，是肯塔基州阿巴拉契亚农村地区的一个重要且尚未得到充分研究的问题。尽管人们试图提高人们对这个问题的认识，但慢性疼痛患者的疼痛仍然得不到充分治疗，包括患有晚期疾病和临终患者。随着人们对处方药滥用和转移的担忧日益加剧，这种情况只会变得更糟。该应用程序旨在在肯塔基大学（英国）和 Hospice of the Bluegrass (HOB) 之间创建一个功能齐全的基于社区的参与性研究 (CBPR) 实体。这种关系的一个主要成果是对一线护理人员（即护士、CNA、社会工作者）进行正式的基于需求的评估，这些护理人员必须处理因处方药滥用和转移问题而闻名的农村人口的疼痛问题。数据将用于确定有效治疗的障碍并为未来的干预研究收集初始数据。需求评估将通过焦点小组、关键知情人访谈以及对 HOB 一线护理人员的评估来进行。将特别关注提供者在适当使用阿片类镇痛药方面的知识库的缺陷。为了实现这一目标，评估工具将包括工人人口统计数据、对其知识基础和疼痛管理态度的调查、工作满意度调查以及一般自我效能感的衡量。将开展一项关于阿片类药物知识和使用恐惧的额外调查以及案例简介，以进一步完善评估包。作为最后一步，该研究将通过在 HOB 进行机构范围内的调查来结束基于需求的评估，以针对未来的应用研究领域，解决与 HOB 及其患者群体相关的临床研究需求的应用。