Mid-Career Mentoring Award in Palliative Care, Aging, and Cognitive Impairment

姑息治疗、老龄化和认知障碍领域的职业生涯中期指导奖

• 批准号: 10683932
• 负责人: David B. Bekelman
• 金额: $ 18.71万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10683932
• 关键词: Adult; Advance Care Planning; Aging; Alzheimer' s disease related dementia; Award; Cardiology; Cardiopulmonary; Caregiver support; Caregiver well-being; Caregivers; Caring; Chronic Obstructive Pulmonary Disease; Clinical; Cognition; Cognitive; Collaborations; Colorado; Consolidated Framework for Implementation Research; Data; Dementia; Development; Disadvantaged; Discipline of Nursing; Disease; Disparity population; Elderly; Environment; Family; Family Caregiver; Funding; Geriatrics; Goals; Health; Heart failure; Hispanic; Impaired cognition; Individual; Internist; Intervention; Knowledge; Medicaid; Medical; Memory; Mentors; Mentorship; Methods; Multi-Institutional Clinical Trial; Outcome; Palliative Care; Participant; Patient Care; Patients; Personal Satisfaction; Persons; Positioning Attribute; Primary Care; Psychiatrist; Psychology; Public Health; Pulmonology; Quality of life; Research; Research Activity; Research Personnel; Resources; Scientist; Screening procedure; Social Work; Specialist; Telephone Interviews; Testing; Thinking; Time; Training; United States National Institutes of Health; Universities; Visit; Work; age related; care outcomes; career; career development; cognitive function; cognitive interview; comorbidity; design; disability; diverse data; effectiveness study; end of life; evidence base; experience; implementation science; improved; interest; intervention effect; mild cognitive impairment; multi-site trial; next generation; patient oriented; patient oriented research; patient population; prevent; primary care patient; primary care practice; primary care setting; programs; rural setting; skills; success; symptom treatment

PROJECT SUMMARY Palliative care focuses on improving quality of life for people with serious illness and their family caregivers at any stage of illness and aligning medical treatments with a persons' values and goals. Older adults with serious illnesses such as heart failure (HF) or chronic obstructive pulmonary disease (COPD) have numerous palliative care needs. However, palliative care is often provided late in illness by palliative care specialists, near the end of life. In addition, palliative care is a limited resource that is not available to many of the patients with HF or COPD and their family caregivers, especially in urban poor and rural settings. Furthermore, many older adults with HF or COPD have comorbid cognitive impairment and dementia which are associated with worse outcomes. In prior work, I tested the effect of early palliative care interventions for adults with HF or COPD. In this application, I propose new research to determine how to adapt and implement early palliative care into the primary care setting for patients with HF or COPD who have cognitive impairment or Alzheimer's disease and related dementias. The overall goals of this proposal are to (1) train mentees (through increased mentoring time) to increase the cadre of successful patient-oriented researchers who will improve care and outcomes for older adults with serious illness and cognitive impairment, and (2) expand my research skills and experience in cognitive impairment and implementation science research for seriously ill older adults in primary care. I will accomplish these goals through additional training, research experience, and mentorship from experts in cognitive impairment, implementation science, and mentoring. During the K24, I will work closely with mentees to develop individual career plans and conduct research to further their development as independent investigators in palliative care, aging, and cognitive impairment. The research proposed in this application will: (1) determine how cognitive impairment influences participation in early palliative care and palliative care outcomes; we will analyze cognitive function and quality of life data from two of my multisite clinical trials (one completed, one active) of older adults with HF or COPD, and (2) engage primary care stakeholders (clinicians, leaders, staff, patients, and caregivers) to identify which palliative care interventions to implement in primary care and how to implement them. The proposed research, conducted with implementation science collaborators and mentees, will provide new knowledge on how to adapt and implement early palliative care into primary care for older adults with HF or COPD and cognitive impairment, including Alzheimer's disease and related dementias. I am thrilled to train the next generation of patient-oriented researchers in palliative care, aging, and cognitive impairment. With my record of research and mentoring success and the resources from the K24 and the University of Colorado, I can provide an outstanding training environment.

项目摘要 姑息治疗的重点是改善严重疾病患者及其家庭照顾者的生活质量， 任何阶段的疾病和调整医疗与一个人的价值观和目标。的老年人 严重的疾病，如心力衰竭（HF）或慢性阻塞性肺病（COPD）， 姑息治疗的需求。然而，姑息治疗通常是在疾病晚期由姑息治疗专家提供的， 生命的终结此外，姑息治疗是一种有限的资源，许多患者无法获得。 HF或COPD及其家庭照顾者，特别是在城市贫困和农村环境中。此外，许多老年人 患有HF或COPD的成年人患有认知障碍和痴呆共病， 结果。在之前的工作中，我测试了早期姑息治疗干预对HF或COPD成人的影响。在 这个应用程序，我提出了新的研究，以确定如何适应和实施早期姑息治疗到 患有认知障碍或阿尔茨海默病的HF或COPD患者的初级保健环境， 相关的痴呆症本提案的总体目标是：（1）培训学员（通过增加辅导 时间），以增加成功的以病人为导向的研究人员的干部，他们将改善护理和结果， 患有严重疾病和认知障碍的老年人，（2）扩大我的研究技能和经验， 认知障碍和实施科学研究的重病老年人在初级保健。我会 通过额外的培训，研究经验和专家的指导来实现这些目标， 认知障碍、实施科学和指导。在K24期间，我将与学员密切合作 制定个人职业规划并进行研究，以促进其独立发展 姑息治疗、衰老和认知障碍的研究者。本申请中提出的研究将： (1)确定认知障碍如何影响早期姑息治疗和姑息治疗的参与 结果;我们将分析我的两项多地点临床试验（一项）的认知功能和生活质量数据 已完成，一个活动）的老年人与HF或COPD，和（2）从事初级保健利益相关者（临床医生， 领导者、工作人员、患者和护理人员），以确定在初级保健中实施哪些姑息治疗干预措施。 以及如何实施。建议的研究，与实施科学进行 合作者和学员，将提供关于如何适应和实施早期姑息治疗的新知识 为患有HF或COPD和认知障碍（包括阿尔茨海默病）的老年人提供初级保健 以及相关的痴呆症我很高兴能在姑息治疗领域培养下一代以病人为导向的研究人员， 护理、衰老和认知障碍。凭借我在研究和指导方面的成功记录以及 从K24和科罗拉多大学，我可以提供一个优秀的培训环境。

项目成果

How Does Spiritual Well-Being Change Over Time Among US Patients with Heart Failure and What Predicts Change?

• DOI: 10.1007/s10943-022-01712-4
• 发表时间: 2022-12-07
• 期刊: JOURNAL OF RELIGION & HEALTH
• 影响因子: 2.8
• 作者: Deng，Lubin R.;Doyon，Katherine J.;Bekelman，David B.
• 通讯作者: Bekelman，David B.

How Important is Spirometry for Identifying Patients with COPD Appropriate for Palliative Care?

• DOI: 10.1016/j.jpainsymman.2022.11.016
• 发表时间: 2023-02-10
• 期刊: JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
• 影响因子: 4.7
• 作者: Lange，Allison V.;Mehta，Anuj B.;Bekelman，David B.
• 通讯作者: Bekelman，David B.

Palliative Care Issues in Aortic Stenosis #467.

主动脉瓣狭窄的姑息治疗问题

• DOI: 10.1089/jpm.2023.0388
• 发表时间: 2023
• 期刊: Journal of palliative medicine
• 影响因子: 2.8
• 作者: Paek,Michelle;Rinderle,Travis;Resnick,Rachel;Bekelman,DavidB
• 通讯作者: Bekelman,DavidB

Relationship Status and Quality Are Associated With Perceived Benefits of Caregiving for People With Heart Failure.

关系状态和质量与护理心力衰竭患者的感知益处相关。

• DOI: 10.1097/jcn.0000000000001093
• 发表时间: 2024
• 期刊: The Journal of cardiovascular nursing
• 作者: Glickman,Amanda;Mikulich-Gilbertson,Susan;AbshireSaylor,Martha;DeGroot,Lyndsay;Bekelman,DavidB
• 通讯作者: Bekelman,DavidB