Critical Care Therapies Associated with Longterm Outcomes After Acute Lung Injury

描述(由申请人提供)：这个K-23奖项将为Kross博士提供一个机会，使他成为一名独立的内科科学家，专注于改善急性肺损伤患者的长期结果。通过她的以病人为中心的研究方案，Kross博士将确定急性肺损伤患者及其家人心理和功能发病率的可改变的危重护理风险因素。重要的是，为了开发新的干预方法，她还将评估一种新的假说，即经历危重疾病和危重护理治疗的患者及其家人之间共享的心理和功能发病率。为了发展为急性肺损伤患者及其家人研究治疗方法和结果的职业生涯，Kross博士提出了一项综合课程，包括设计、实施和发表临床研究项目的实践经验；流行病学、生物统计学和卫生服务研究的课程；以及由专家进行的关于危重疾病的心理和功能结果的密集指导。Kross博士将利用这一K23奖项成为一名独立资助的临床研究员，拥有设计和实施急性肺损伤患者及其家人的临床研究的技能。此外，她还将发展以调查为基础的结果评估、标准化病历摘要、集群和纵向统计方法以及定性数据收集和分析方面的专业知识。这一职业发展计划将导致一个成功和独立的研究职业生涯，重点是了解和改善急性肺损伤的长期结果。为了实现这些目标，Kross博士将进行一项前瞻性队列研究，以：1)确定急性肺损伤患者心理和功能发病率的可调性重症监护预测指标之间的关联；2)确定急性肺损伤患者家属心理和功能发病率的可调性危重预测指标之间的关联；3)确定急性肺损伤存活者的心理和功能发病率与其家人的心理和功能发病率之间的关联；以及4)使用定性方法探索潜在的危重病护理干预方法，以改善患者及其家人的长期结局。本项目对急性肺损伤患者及其家属具有重要意义。为急性肺损伤患者及其家属的长期心理症状和功能状态下降确定可改变的重症监护危险因素，将有助于未来重症监护干预措施的发展，以减少急性肺损伤的这些后果。

DESCRIPTION (provided by applicant): This K-23 award will provide an opportunity for Dr. Kross to become an independent physician scientist focused on improving long-term outcomes for patients with acute lung injury. Through her patient-oriented research proposal, Dr. Kross will identify modifiable critical care risk factors for psychological and functional morbidity among patients with acute lung injury and their family members. Importantly, in order to develop innovative approaches for intervention, she will also evaluate a novel hypothesis of psychological and functional morbidity shared between patients experiencing critical illness and critical care therapies and their families. With the goal of developing a career studying therapies and outcomes for patients with acute lung injury, as well as their families, Dr. Kross proposes an integrated curriculum consisting of practical experience in designing, conducting and publishing clinical research projects; coursework in epidemiology, biostatistics and health services research; and intensive mentoring by experts in the psychological and functional outcomes of critical illness. Dr. Kross will use this K23 award to become an independently funded clinical investigator with skills in the design and conduct of clinical studies of patients with acute lung injury and their families. Moreover, she will develop expertise in survey-based outcome assessment, standardized medical record abstraction, clustered and longitudinal statistical methods, and qualitative data collection and analysis. This career development plan will lead to a successful and independent research career focused on understanding and improving long-term outcomes of acute lung injury. To achieve these goals Dr. Kross will conduct a prospective cohort study to: 1) identify associations between modifiable critical care predictors of psychological and functional morbidity for patients with acute lung injury; 2) identify associations between modifiable critical care predictors of psychological and functional morbidity for families of patients of acute lung injury; 3) identify associations between psychological and functional morbidity for patients surviving acute lung injury and psychological and functional morbidity for their families; and 4) use qualitative methods to explore potential critical care approaches to interventions that will improve long-term outcomes for patients and their families. This project has important implications for patients with acute lung injury and their families. The identification of modifiable critical care risk factors for long-term psychological symptoms and decreased functional status for both patients with acute lung injury and their families will inform the development of future critical care interventions to reduce these consequences of acute lung injury.