Timeliness of Symptom Recognition, Interpretation, and Reporting in Heart Failure

描述(由申请者提供)：这一K99/R00奖项将为Reeder博士提供教育和指导研究学习经验，以实现作为一名独立研究员的成功。里德博士的研究计划旨在改善心血管疾病患者的自我管理和临床护理结果，心血管疾病是美国的头号杀手。K99/R00课程和指导研究活动将支持1)临床研究研究的实施，以探索成年心力衰竭(HF)患者如何识别、解释和报告症状，2)使用新型贝叶斯分析验证关于HF症状识别、解释和报告的理论和临床访谈问卷的内容和结构有效性，3)发展关于HF自我管理的知识，涉及症状识别、解释和报告，以及4)开发和提交未来干预研究建议，以经验性地检验循证干预的效果，该调查结果基于K99/R00研究对HF结果的了解。Reeder博士拥有强大的研究支持和培训团队，其中包括Carol Smith，博士，RN，教授，KU-son和预防医学导师，拥有连续23年NIH资助的研究和长期指导研究生、住院医师、博士后研究员和初级教员的历史，这些人已经成为成功的独立研究人员，以及共同导师Byron Gajesski博士，KU生物统计学系副教授。在K99奖项阶段，Reeder博士还将得到3位重要贡献者的支持，他们是一位国际知名的医疗保健经济学家和结果研究员、一位拥有大量NIH结果研究资金的心脏病专家以及一位模范数据库开发专家。Reeder博士的许多研究开发活动将借鉴KUMC的跨学科研究开发计划、资源和研讨会。拟议的教育活动将为里德博士提供新的知识，这对于开发一个独立的研究计划，以改善心血管疾病患者的预后是不可或缺的。Reeder博士将通过临床研究研究中相应的指导研究活动应用这一知识，这项研究题为“HF中症状识别、解释和报告的及时性”，作为她的学术研究论文和当前立场的合乎逻辑的进展。Reeder博士的博士论文评估了社会互动对急性心肌梗死(AMI)院前延迟的影响，在此基础上，Reeder博士将使用探索性描述性设计，通过使用创新的日期重建数据收集方法和新颖的贝叶斯分析来研究症状识别、解释和报告。最终目标是一个独立的研究计划，以促进心血管疾病的有效自我管理，提高护理质量，并降低成本。 公共卫生相关性：这项研究与公共卫生优先事项的相关性在于，它探索了患者用于监测其身体变化和症状的自我管理方法，以及向医疗保健提供者报告心力衰竭症状的及时性。了解患者的治疗方法可以帮助医疗保健提供者找到改善心力衰竭状态的方法，并减少不及时的、反复的心力衰竭住院治疗。

DESCRIPTION (provided by applicant): This K99/R00 award will provide education and mentored research study experiences for Dr. Reeder to achieve success as an independent investigator. Dr. Reeder's program of research is aimed at improving self- management and clinical care outcomes of patients with cardiovascular disease, the nation's number-one killer. K99/R00 coursework and mentored research activities will support 1) implementation of a clinical research study to explore how adult patients living with heart failure (HF) recognize, interpret, and report symptoms, 2) verification of the content and construct validity of a theoretical and clinically-based interview questionnaire on HF symptom recognition, interpretation, and reporting using novel Bayesian analyses, 3) advancement of knowledge about self-management of HF, with respect to symptom recognition, interpretation, and reporting, and 4) development and submission of a future intervention research proposal to examine empirically the effect of an evidence-based intervention that is informed by findings from this K99/R00 study on HF outcomes. Dr. Reeder has strong research support and training from a team that includes Carol Smith, PhD, RN, professor, KU-SON and Preventive Medicine, mentor, with 23 consecutive years of NIH-funded research and a long history of mentoring graduate students, medical residents, post doctoral fellows, and junior faculty who have become successful independent researchers, and co-mentor, Byron Gajewski, PhD, associate professor, KU Department of Biostatistics. During the K99 phase of the award, Dr. Reeder will also have the support of 3 significant contributors, an internationally known health care economist and outcomes researcher, a cardiologist with extensive NIH outcomes research funding, and an exemplary data base development specialist. Many of Dr. Reeder's research development activities will draw from KUMC's interdisciplinary research development programs, resources, and seminars. Proposed educational activities will provide Dr. Reeder with new knowledge integral to developing an independent program of research to improve outcomes for people living with cardiovascular diseases. Dr. Reeder will apply this knowledge through corresponding mentored research activities within a clinical research study, entitled "Timeliness of Symptom Recognition, Interpretation, and Reporting in HF," as a logical progression of her academic research dissertation and current position. Building on her doctoral dissertation that evaluated the influences of social interactions on pre-hospital delay in acute myocardial infarction (AMI), Dr. Reeder will use an exploratory descriptive design to investigate symptom recognition, interpretation, and reporting by employing both the innovative Day Reconstruction Method for data collection and novel Bayesian analysis. The ultimate goal is an independent program of research to promote effective self-management of cardiovascular diseases, enhance quality of care, and reduce costs. PUBLIC HEALTH RELEVANCE: The relevance of this research to public health priorities is that it explores patients' self-management methods used to monitor their bodily changes and symptoms and the timeliness of reporting heart failure symptoms to health care providers. Understanding patient methods can help health care providers to identify ways improve heart failure status and reduce untimely, repeated heart failure hospitalizations.