Improving Health Outcomes Through Enhanced Patient-Provider Relationships

通过加强患者与提供者的关系改善健康结果

• 批准号: 9318450
• 负责人: Michelle L Dossett
• 金额: $ 16.48万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9318450
• 关键词: Acids; Affect; Area; Arts; Assessment tool; Autonomic nervous system; Behavior; Behavioral; Behavioral Mechanisms; Biological Markers; Biological Models; Biometry; Caring; Characteristics; Chin; Chronic; Clinical Management; Clinical Trials; Complementary Medicine; Complex; Cues; Data; Development; Doctor of Philosophy; Empathy; Environment; Facial Expression; Feeling; Foundations; Frequencies; Galvanic Skin Response; Gastroesophageal reflux disease; Goals; Head; Health; Health Personnel; Hearing; Heartburn; Human; Individual; Integrative Medicine; Interview; K-Series Research Career Programs; Measurable; Measurement; Measures; Mediating; Medical; Medicine; Mentors; Methods; Mind-Body Intervention; Observational Study; Omeprazole; Outcome; Patient-Focused Outcomes; Patients; Perception; Pharmaceutical Preparations; Physicians; Physiological; Pilot Projects; Population; Process; Provider; Qualitative Research; Quality of Care; Randomized Controlled Trials; Recording of previous events; Reflux; Reporting; Research; Research Personnel; Resources; Science; Severities; Stress; Symptoms; Testing; Therapeutic; Time; Training; Training Support; Validation; Visit; Work; behavioral response; career; career development; clinically relevant; design; experience; healing; heart rate variability; improved; insight; interest; laboratory experience; multidisciplinary; neural correlate; rapid growth; research study; response; symptomatic improvement

Project Summary / Abstract This K23 career development award will support the training and career development of the Candidate to develop expertise in measuring and evaluating patient-provider relationships – the core of the healing arts – and their effects on health outcomes. While this relationship influences symptoms in many different conditions, we know little about the mechanisms underlying its effect or how to augment it. The rapid growth of complementary and integrative medicine (IM) may, in part, be due to a qualitative difference in patient-provider relationships compared to conventional medicine. Training in three critical areas will facilitate the Candidate’s transition to independence: 1) measurement and analysis of physiologic biomarkers of autonomic nervous system activity including galvanic skin response (GSR) and heart rate variability (HRV); 2) design, execution, and analysis of qualitative research with a focus on analysis of videos of patient-provider interactions; and 3) design and management of clinical trials and relevant biostatistical analyses. These training goals will be supported by 1) a stellar team of mentors and consultants – Maurizio Fava, MD (primary mentor), John Denninger, MD, PhD (co-mentor), and consultants Chin Hur, MD, MPH, Prof.Ted Kaptchuk, Eric Macklin, PhD, Vitaly Napadow, PhD, Elyse Park, PhD, MPH, and Cheng-Kang Peng, PhD; 2) a resource-rich institutional environment; 3) targeted advanced coursework, mentored laboratory experiences, and research seminars; and 4) the proposed research studies. Using gastroesophageal reflux disease (GERD) as a model system, the proposed studies will seek to 1) identify physiologic responses associated with GERD symptom improvement in enhanced patient-provider interactions, 2) use qualitative approaches to determine the visit characteristics associated with the identified physiologic responses, and 3) determine whether enhanced patient-provider interactions (similar to an IM provider visit) vs. empathic, conventional medical visits can augment the effect of omeprazole on GERD symptom improvement in a pilot randomized controlled trial. Results of the proposed studies will provide insights into the mechanisms underlying effective patient-provider relations, preliminary data for an R01 application, and will effectively lay the foundation for a career focused on studying patient- provider relations and their effects on health outcomes. While initial studies will focus on GERD, it is anticipated that the mechanisms identified will be broadly applicable to range of different health conditions and have implications for improving quality of care in the conventional medical setting and training of healthcare providers.

项目总结/摘要 该K23职业发展奖将支持候选人的培训和职业发展， 发展测量和评估患者-提供者关系的专业知识-愈合艺术的核心- 及其对健康结果的影响。虽然这种关系在许多不同的情况下影响症状， 我们对它的作用机制以及如何增强它知之甚少。 补充和综合医学（IM）可能部分是由于患者-提供者之间的质的差异 与传统医学相比。三个关键领域的培训将有助于候选人 向独立性过渡：1）自主神经生理标志物的测量和分析 系统活动，包括皮肤电反应（GSR）和心率变异性（HRV）; 2）设计，执行， 定性研究分析，重点分析患者与提供者互动的视频;以及3） 临床试验和相关生物统计分析的设计和管理。这些培训目标将是 支持1）导师和顾问的恒星团队- Maurizio Fava，医学博士（主要导师），约翰 Denninger，医学博士，博士（共同导师）和顾问Chin Hur，医学博士，公共卫生硕士，Ted Kaptchuk教授，Eric Macklin，博士， Vitaly Napadow博士，Elyse Park博士，公共卫生硕士和Cheng-Kang Peng博士; 2）资源丰富的机构 环境; 3）有针对性的高级课程，指导实验室经验和研究研讨会; 4)建议的研究。使用胃食管反流病（GERD）作为模型系统， 拟议的研究将寻求1）确定与GERD症状改善相关的生理反应 在增强的患者-提供者互动中，2）使用定性方法来确定就诊特征 与所识别的生理反应相关联，以及3）确定增强的患者-提供者是否 互动（类似于IM提供商访问）与移情，传统的医疗访问可以增强 奥美拉唑对GERD症状改善的初步随机对照试验。拟议预算的结果 研究将提供深入了解有效的患者-提供者关系的机制，初步 数据的R 01应用程序，并将有效地奠定了职业生涯的基础，专注于研究病人- 提供者关系及其对健康结果的影响。虽然最初的研究将集中在胃食管反流病， 预计所确定的机制将广泛适用于各种不同的健康状况， 对提高传统医疗环境和医疗保健培训的护理质量具有影响 提供商