Midcareer Investigator Award in Patient-Oriented Research: Yael Schenker, MD, MAS

摘要：老年晚期癌症患者人数不断增加， 公共卫生问题，包括生活质量急剧下降，接受的护理不能反映 患者的价值观和偏好，以及高比率的照顾者负担。对患者关注不足 优先事项和与年龄有关的问题（例如，功能，认知和社会支持）-有助于 这一人群的发病率。新兴的老年姑息治疗领域旨在解决与年龄有关的 在慢性和严重疾病的发展轨迹上，关注和调整护理与患者目标。的 这个K24提案的总体目标是加强候选人对学生，研究员， 以及从事老年姑息治疗研究的初级教师，特别关注识别未满足的需求 老年姑息治疗需求，制定和测试干预措施，以提高生活质量， 老年晚期癌症患者的目标一致护理。作为一个成功的职业调查员 有着领先的成功的姑息性干预试验的记录， 候选人有能力指导下一代老龄化研究人员。这个奖项将 利用400多个音频记录的“初级”姑息治疗访问的优秀纵向数据集 与晚期癌症老年患者和纵向患者-和-报告的结果， 探索最佳的老年姑息治疗干预设计。本研究的目的是（1）表征 在初级姑息治疗访视中与老年人沟通与年龄相关的问题， 晚期癌症及其家庭护理人员;（2）确定错过的解决年龄问题的机会- 晚期癌症老年人及其家人初级姑息治疗访视的相关问题 护理人员;（3）完善初级姑息治疗提供的概念模型，包括年龄- 相关的问题，并可以优化，以提高生活质量的老年人与先进的癌症。 K24奖将为候选人提供受保护的时间，以更新和扩大她的指导 该计划，在老年医学，姑息治疗和肿瘤学研究人员之间建立桥梁。她将 利用匹兹堡大学优秀的老龄化研究和指导资源; 学习新技能，以促进学员的探究，福祉和复原力;并创建一个初级学院 老年姑息治疗研究人员客座教授计划。这一建议意义重大， 创新，因为它将支持新的临床研究者使用新的指导技术， 开发试点数据，为大规模试验提供信息，以解决新兴医疗服务质量方面的缺陷。 患有晚期癌症的老年人。这是非常可行的，因为候选人是一个 致力于导师与持续的R 01资金，从一个优秀的研究环境与强大的 老年医学项目和大量潜在的学员。

ABSTRACT: The growing population of older adults with advanced cancer experiences significant public health problems, including steep declines in quality of life, receipt of care that does not reflect patients' values and preferences, and high rates of caregiver burden. Inadequate attention to patient priorities and age-related concerns (e.g., function, cognition, and social support)—contribute to morbidity in this population. The emerging field of geriatric palliative care seeks to address age-related concerns and align care with patient goals over the trajectory of chronic and serious illness. The overarching goal of this K24 proposal is to enhance the candidate's mentorship of students, fellows, and junior faculty pursuing geriatric palliative care research, with a particular focus on identifying unmet geriatric palliative care needs and developing and testing interventions to improve quality of life and goal-concordant care for older patients with advanced cancer. As a successful mid-career investigator with a track record of leading successful palliative intervention trials with seriously ill older patients, the candidate is well-positioned to mentor the next generation of aging researchers. This award will leverage an outstanding longitudinal dataset of over 400 audio-recorded `primary' palliative care visits with older patients with advanced cancer and longitudinal patient- and caregiver-reported outcomes to explore optimal geriatric palliative care intervention designs. The research aims are to (1) characterize communication about age-related concerns in primary palliative care visits with older adults with advanced cancer and their family caregivers; (2) identify missed opportunities for addressing age- related concerns in primary palliative care visits for older adults with advanced cancer and their family caregivers; and (3) refine a conceptual model for primary palliative care delivery that incorporates age- related concerns and can be optimized to improve quality of life for older adults with advanced cancer. The K24 award will provide protected time for the candidate to update and expand her mentorship program, building bridges between researchers in geriatrics, palliative care and oncology. She will leverage outstanding aging research and mentoring resources available at the University of Pittsburgh; learn new skills to foster inquiry, wellbeing and resilience among trainees; and create a Junior Faculty Visiting Professor Program for geriatric palliative care researchers. This proposal is significant and innovative because it will support new clinical investigators using novel mentoring techniques and develop pilot data to inform large-scale trials addressing deficiencies in quality of care for a burgeoning population of older adults with advanced cancer. It is highly feasible because the candidate is a committed mentor with ongoing R01 funding, from an outstanding research environment with strong geriatrics programs and a large pool of potential mentees.