Expanding Treatment Options for Older Persons

扩大老年人的治疗选择

• 批准号: 8113208
• 负责人: Terri R. Fried
• 金额: $ 18.38万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8113208
• 关键词: Advance Care Planning; Aging; Biometry; Caregivers; Caring; Communities; Comorbidity; Decision Making; Discipline; Documentation; Educational Curriculum; Elderly; Environment; Epidemiology; Frequencies; Goals; Health Policy; Health behavior; Individual; Measures; Medical; Mentorship; Methods; Midcareer Investigator Award in Patient-Oriented Research; Modeling; Participant; Patients; Perception; Persons; Population; Postdoctoral Fellow; Predisposition; Principal Investigator; Process; Psychiatry; Public Health; Qualitative Methods; Readiness; Research; Research Infrastructure; Resources; School Nursing; Schools; Self Efficacy; Severities; Staging; Time; Training; Training Programs; Work; base; career; career development; data management; experience; health belief; insight; medical schools; meetings; patient oriented; preference; programs; shared decision making; skills

DESCRIPTION (provided by applicant): The specific aim of the Midcareer investigator Award in Patient-Oriented Research is to provide the Principal Investigator with sufficient protected time in order: 1) to expand a research program devoted to enhancing the frequency and quality of shared decision-making for older persons in order to provide patients with care that best meets their treatment preferences and 2) to formalize a mentorship program focused on providing interdiscplinary mentorship to trainees from a diverse range of disciplines and schools pursuing aging research. The research program will build upon Dr. Fried's past work to: a) utilize health behavior models to explicate advance care planning as a health behavior and b) develop methods to elicit the preferences of older persons with multiple comorbidities. This program will utilize mixed qualitative- quantitative methods to provide greater insight into older persons' experiences with and perceptions of difficult treatment decision-making and to develop patient-centered measures. The mentorship program will utilize the resources described below to provide core educational and career development experiences. Building upon these, the trainee's individual research program will serve as the core of the mentorship program, and it will be supplemented by mentorship regarding skills critical to a successful research career and specific career guidance. The mentorship program will be based on an explicit consideration and documentation of the trainee's goals, a mentorship plan tailored to meet these goals, and regular review of how well the plan is assisting the trainee to meet his/her goals. The environment of the Yale School of Medicine offers extensive resources to support both the research and mentorship programs. These include a number of training programs that attract a large number of talented post-doctoral fellows and that provide well-developed curricula, opportunities for advanced didactic training in biostatistics, epidemiology, and health policy, and, through the Yale Program on Aging/Pepper Center, a research infrastructure providing skilled field, data management, and biostatistical support as well as access to a broad range of populations. In addition, the research and mentorship programs will utilize and continue to build the interdisciplinary relationships Dr. Fried has established with medical subspecialties, psychiatry, and the Schools of Nursing and Public Health.

说明（由申请人提供）：以患者为导向的研究中的职业中期研究者奖的具体目标是为首席研究员提供足够的保护时间，以便：1）扩大致力于提高老年人共同决策的频率和质量的研究计划，以便为患者提供最符合其治疗偏好的护理，2）正式制定一个指导计划，重点是为来自不同领域的受训者提供跨学科指导 从事老龄化研究的学科和学校。该研究计划将以弗里德博士过去的工作为基础：a）利用健康行为模型将预先护理计划解释为一种健康行为；b）开发方法来了解患有多种合并症的老年人的偏好。该计划将利用混合定性定量方法来更深入地了解老年人对困难治疗决策的经历和看法，并制定以患者为中心的措施。导师计划将利用下述资源提供核心教育和职业发展经验。在此基础上，受训者的个人研究计划将作为指导计划的核心，并辅之以对成功研究生涯至关重要的技能指导和具体的职业指导。指导计划将基于对受训者目标的明确考虑和记录、为实现这些目标而量身定制的指导计划，以及定期审查该计划如何帮助受训者实现他/她的目标。耶鲁大学医学院的环境提供了广泛的资源来支持研究和指导项目。其中包括许多吸引大量有才华的博士后研究员的培训项目，提供完善的课程、生物统计学、流行病学和卫生政策方面的高级教学培训机会，以及通过耶鲁大学老龄化项目/佩珀中心提供研究基础设施，提供技术领域、数据管理和生物统计支持以及接触广泛人群的机会。此外，研究和指导计划将利用并继续建立弗里德博士与医学专业、精神病学以及护理和公共卫生学院建立的跨学科关系。

项目成果

Designing health care for the most common chronic condition--multimorbidity.

• DOI: 10.1001/jama.2012.5265
• 发表时间: 2012-06-20
• 期刊: JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
• 影响因子: 120.7
• 作者: Tinetti, Mary E.;Fried, Terri R.;Boyd, Cynthia M.
• 通讯作者: Boyd, Cynthia M.

Primary care clinicians' experiences with treatment decision making for older persons with multiple conditions.

初级保健临床医生对有多种疾病的老年人进行治疗决策的经验。

• DOI: 10.1001/archinternmed.2010.318
• 发表时间: 2011-01-10
• 期刊: ARCHIVES OF INTERNAL MEDICINE
• 作者: Fried, Terri R.;Tinetti, Mary E.;Iannone, Lynne
• 通讯作者: Iannone, Lynne

Redefining the "planning" in advance care planning: preparing for end-of-life decision making.

• DOI: 10.7326/0003-4819-153-4-201008170-00008
• 发表时间: 2010-08-17
• 期刊: Annals of internal medicine
• 影响因子: 39.2
• 作者: Sudore RL;Fried TR
• 通讯作者: Fried TR

Development of a tool to improve the quality of decision making in atrial fibrillation.

开发一种工具，以提高房颤中决策的质量。

• DOI: 10.1186/1472-6947-11-59
• 发表时间: 2011-10-06
• 期刊: BMC medical informatics and decision making
• 影响因子: 3.5
• 作者: Fraenkel L;Street RL Jr;Fried TR
• 通讯作者: Fried TR