Psychological support based on positive suggestions in acute respiratory failure patients

基于积极建议的急性呼吸衰竭患者心理支持

• 批准号: 10532230
• 负责人: Lioudmila Karnatovskaia
• 金额: $ 18.58万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-12-24 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10532230
• 关键词: Acute respiratory failure; Address; Affect; American; Analgesics; Anxiety; Behavior Therapy; Chest; Chronic; Clinical; Cognitive; Collaborations; Communication; Complication; Conscious; Critical Illness; Data; Delirium; Elements; Emotional; Evaluation; Family; Feasibility Studies; Feedback; Foundations; Fright; Funding; Goals; Grant; Health Care Costs; Health Personnel; Hospitals; Hungary; Impairment; Inpatients; Intensive Care; Intensive Care Units; Intervention; Intervention Studies; Interview; Intubation; K-Series Research Career Programs; Measures; Mechanical ventilation; Medical; Memory; Mental Depression; Mental Health; Mentors; Mission; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Nurses; Outcome; Patients; Persons; Physical Rehabilitation; Physicians; Pilot Projects; Population; Positioning Attribute; Post-Traumatic Stress Disorders; Prevention; Process; Provider; Psychologist; Psychology; Psychotherapy; Quality of life; Randomized; Randomized, Controlled Trials; Research; Research Design; Research Personnel; Risk Factors; Services; Societies; Standardization; Structure; Suggestion; Survivors; Syndrome; Testing; Therapeutic; Thinking; Time; Training; Treatment Efficacy; Universities; Weaning; Woman; Work; acute stress; anxiety symptoms; career; cognitive function; comparative efficacy; cost; design; effectiveness testing; efficacy study; emotional experience; experience; follow-up; improved; improved outcome; instrument; interest; intervention refinement; modifiable risk; patient oriented research; prevent; professor; psychologic; psychological distress; readmission rates; reduce symptoms; sedative; semantic processing; skills; survivorship; traumatic event; treatment as usual; ventilation

PROJECT SUMMARY/ABSTRACT Up to two thirds of those who survive acute respiratory failure (ARF) requiring mechanical ventilation suffer from symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD) after leaving the intensive care unit (ICU). Memories of frightening and delusional experiences in the ICU appear to be the strongest potentially modifiable risk factor. Research on the formation of fear and associated memories shows that if mitigating information about a traumatic event is introduced during the time between memory formation and its recall, the emotional experience of the memory can be modified in a positive manner. This means that in order to prevent mental health problems in ARF patients, psychological support needs to take place in parallel with medical treatment in the ICU. Previously, application of Psychological Support Based on Positive Suggestions (PSBPS) resulted in shorter duration of mechanical ventilation and decreased need for sedatives. We hypothesize that PSBPS can also mitigate mental health morbidity in ARF survivors. However, providing reliable PSBPS intervention is a challenge for busy ICU clinicians. Doulas, trained lay health care providers who provide emotional support to women in labor have been identified as a reliable yet affordable alternative. Given common elements of their services and our intervention, doulas are in an ideal position to administer PSBPS. The objective of this project is to refine and test a behavioral intervention to be administered in parallel with medical treatment in the ICU. This will be accomplished through two specific aims, which are: 1) to complete the pilot PSBPS with trained doulas and to refine the intervention based on stakeholder feedback and 2) to conduct a randomized controlled trial to evaluate the potential efficacy of PSBPS vs usual care in ARF patients on mental health morbidity and cognitive outcomes. In AIM 1, PSBPS will be performed on 30 ARF patients with subsequent semi-structured interviews of all involved stakeholders; patients will also complete anxiety, depression, acute stress/PTSD, and cognitive function evaluation as measured by validated instruments. For AIM 2, we will conduct a randomized, controlled trial to test the effectiveness of PSBPS. We hypothesize that ARF patients who receive standardized EPSCI will have fewer symptoms of anxiety, depression and acute stress/PTSD at ICU discharge and at 6-month follow-up, and better cognitive function. The proposed Career Development Award supports the NHLBI mission by striving to improve outcomes in ARF patients while training a junior investigator in essential skills to become an independent researcher.

项目总结/文摘