Quality of Mental Health Care in Assisted Living

描述（由申请人提供）：这是一份申请K01指导研究科学家职业发展奖的申请。该候选人是一名流行病学老年学家，建议获得与卫生服务研究（HSR）领域相关的特定技能和知识。候选人的长期职业目标是成为一名成功的，高效的独立调查员，专注于多种环境中老年人精神健康障碍的流行病学和护理。在博士的指导下。p·v·拉宾斯和c·g·莱克索斯，以及两位博士的监督。S. Zimmerman, a . Rosenblatt， E. Stuart， N. Castle， M. Bruce和L. Morgan，候选人将执行一个5年的职业发展计划。短期目标是：(1)通过开展一项前瞻性研究，专注于辅助生活中设施级精神卫生保健，获得实践领域和领导经验；(2)加强对高铁原理和方法的认识以及老年人在卫生保健机构的经验；(3)建立扎实的高铁仪器开发原理知识基础；(4)通过与相关领域领导者的互动和合作，培养未来精神卫生服务研究工作的独立性；(5)进行负责任的研究培训。这些目标将通过教学培训（例如约翰·霍普金斯大学公共卫生学院的9门课程）来实现；临床观察（如老年精神病学、门诊门诊门诊、长期护理）；结构化和非结构化网络（例如，与导师/合作者的定期联系；出席会议；前往进行平行研究的地点）；并开展一项研究项目。本研究的目的是：(1)开发一种基于证据的工具来测量辅助生活（AL）中精神卫生保健质量的设施水平指标；(2)利用该仪器对随机抽样的ALs的质量指标进行量化；(3)评估非痴呆症专科护理区（ndsca）和痴呆症专科护理区（dsca）之间质量指标存在的差异；(4)在试点样本中评估质量指标与居民水平特征的关系，以确定效应量估计和未来R01应用的方法。这些技能和经验的整合将使候选人对多层次因素背景下的精神卫生服务研究有深刻的理解。相关性：精神障碍在AL环境中非常普遍，并与许多不良后果相关，包括提前出院到养老院和较差的生活质量。随着越来越多的精神疾病发病率较高的老年人利用这种护理环境，人们对精神卫生保健质量产生了重大的公共卫生关切。提出的研究既重要又及时，并将提供一种新的精神卫生保健质量工具，用于AL和存在循证质量指标的经验数据。

DESCRIPTION (provided by applicant): This is an application for a K01 Mentored Research Scientist Career Development Award. The candidate is an epidemiological gerontologist who proposes to acquire specific skills and knowledge related to the field of health services research (HSR). The candidate's long-term career goal is to become a successful, highly productive independent investigator focusing on the epidemiology and care of mental health disorders for elders in multiple settings. Under the mentorship of Drs. P.V. Rabins and C.G. Lyketsos, and the supervision of Drs. S. Zimmerman, A. Rosenblatt, E. Stuart, N. Castle, M. Bruce, and L. Morgan, the candidate will carry out a 5-year career development plan. Short-term goals are to (1) gain practical field and leadership experience by conducting a prospective study focused on facility-level mental health care in assisted living; (2) enhance knowledge of HSR principles and methods and of elders' experiences in health care settings; (3) develop a solid knowledge base in principles of HSR instrument development; (4) foster independence for future work in mental health services research through interactions and collaborations with leaders in related fields; and (5) train in the conduct of responsible research. These goals will be accomplished through didactic training (e.g. 9 courses at the Johns Hopkins School of Public Health); clinical observation (e.g. geriatric psychiatry, ambulatory care outpatient clinics, long-term care); structured and unstructured networking (e.g., regular contact with the mentors/collaborators; conference attendance; travel to sites conducting parallel research); and carrying out a research project. The aims of research project are to: (1) develop an evidence-based instrument to measure facility-level indicators of mental health care quality in assisted living (AL); (2) use the instrument to quantify quality indicators in a random sample of ALs; (3) evaluate differences in the presence of quality indicators between non-dementia-specific care areas (NDSCAs) and dementia-specific care areas (DSCAs); and (4) evaluate the relationship of quality indicators with resident- level characteristics in a pilot sample to ascertain effect size estimates and methods for a future R01 application. Integration of these skills and experiences will provide the candidate with a deep understanding of mental health services research in the context of multi-level factors. RELEVANCE: Mental disorders are highly prevalent in the AL setting and are associated with a number of adverse outcomes including early discharge to nursing homes and poorer quality of life. As more elders with greater psychiatric morbidity utilize this care setting, there are significant public health concerns about mental health care quality. The proposed research is both critical and timely and will provide a new mental health care quality instrument for use in AL and empirical data on presence of evidenced-based quality indicators.