Sleep and Cognition after Left Ventricular Assist Device Implantation

左心室辅助装置植入后的睡眠和认知

• 批准号: 10382700
• 负责人: Tao ZHENG
• 金额: $ 4.68万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10382700
• 关键词: Address; Anxiety; Arousal; Attention; Attention Concentration; Auditory; Award; Cardiac Output; Caring; Clinical; Cognition; Data; Data Collection; Destinations; Devices; Drowsiness; Elderly; Event; Fellowship; Foundations; Fright; Future; Goals; Health; Heart Transplantation; Heart failure; Home; Impaired cognition; Impaired health; Implant; Implantation procedure; Individual; Individual National Research Service Award; Influentials; Intervention; Investigation; Israel; Knowledge; Language; Life; Life Style Modification; Link; Literature; Measures; Mechanics; Medical; Memory Loss; Mental Depression; Mental Health; Methods; Neurobehavioral Manifestations; Nursing Research; Operative Surgical Procedures; Organ; Outcome; Patients; Persons; Physiological; Population; Postoperative Pain; Postoperative Period; Pump; Quality of life; Recovery; Refractory; Research; Research Personnel; Research Training; Risk; Schedule; School Nursing; Science; Sleep; Sleep Disorders; Sleep disturbances; Space Perception; Speed; Symptoms; Technology; Therapeutic; Time; To specify; Training; Transplantation; Treatment Failure; Universities; Visuospatial; Washington; actigraphy; anxiety symptoms; biobehavior; biomaterial compatibility; cognitive function; comorbidity; doctoral student; executive function; experience; health related quality of life; high risk; implantable device; implantation; improved; innovation; left ventricular assist device; mechanical circulatory support; mortality; novel; optimal treatments; physical symptom; poor sleep; portability; pre-doctoral; processing speed; programs; prospective; psychologic; psychological distress; psychological symptom; reduce symptoms; respiratory; sleep onset; sleep quality; symptom management; symptomatic improvement; symptomatology; therapy development; visual memory

PROJECT SUMMARY The purpose of this Ruth L. Kirschstein National Research Service Award (NRSA) Individual Pre-Doctoral Fellowship in Nursing Research (F31) application is to provide research training for Mr. Zheng, a second-year doctoral student at the University of Washington School of Nursing. The long-term goal of this training is for this applicant to develop into an independent influential researcher in a research-intensive academic setting with an innovative and productive interdisciplinary program. This research will be dedicated to integrating physiologic measures into bio-behavioral interventions to reduce and ameliorate symptom burden in individuals with advanced heart failure (AHF) and mechanical circulatory support (MCS) devices. Individuals with AHF experience severe refractory symptom burden despite maximum medical therapy. Cardiac transplant is the optimal treatment option for AHF. However, organ shortage and ineligibility for transplant make MCS devices, such as Left Ventricular Assist Devices (LVADs), the only treatment option for individuals with advanced age and comorbid conditions requiring permanent support, known as destination therapy (DT). The number of patients attaining longer-term survival with DT-LVAD is rapidly growing with increased durability of mechanical support, and expanded indications for DT-LVAD to include patients in earlier stages of heart failure. While studies on sleep and sleep disorders among individuals with heart failure are extensive, investigating sleep as an important clinical outcome for DT-LVAD recipients has not kept pace with the rapidly expanding therapeutic indications and evolving technology advancements in MCS for AHF care. Better understanding of LVAD effects on physical and psychological symptoms will be essential to effectively care for, and support LVAD patients post-implant. The purpose of this prospective concurrent mixed-methods study is to describe changes in objective and subjective sleep quality at 3 months in persons with AHF following DT-LVAD, and to determine associations between change in sleep quality as they relate to changes in cognitive function, psychological symptoms and health-related quality of life. Moreover, this award will prepare a pre-doctoral trainee through advanced coursework and direct research experience, the use of mixed methods, focused analysis of symptom changes observed post-LVAD implant, and discovery of highly relevant links among multiple sleep and AHF-related symptoms. Findings generated from this investigation will provide foundational knowledge for building a new program of research in symptom and symptom management science in AHF.

项目摘要 这个Ruth L的目的。Kirschstein国家研究服务奖（NRSA）个人博士预科 申请护理研究奖学金（F31）是为郑先生提供研究培训的第二年 他是华盛顿大学护理学院的博士生。本次培训的长期目标是 这个申请人发展成为一个独立的有影响力的研究人员在研究密集型的学术环境 一个创新和富有成效的跨学科计划。这项研究将致力于整合 将生理措施纳入生物行为干预措施，以减轻和改善个体的症状负担 晚期心力衰竭（AHF）和机械循环支持（MCS）设备。AHF患者 尽管进行了最大限度的药物治疗，但仍存在严重的难治性症状负担。心脏移植是 AHF的最佳治疗方案。然而，器官短缺和不适合移植使得MCS设备， 例如左心室辅助装置（LVAD），这是高龄患者的唯一治疗选择 和需要永久支持的共病状况，称为目的地治疗（DT）。的数量 使用DT-LVAD获得长期生存的患者随着机械耐久性的增加而迅速增加 支持，并扩大了DT-LVAD的适应症，以纳入心力衰竭早期患者。而 对心力衰竭患者的睡眠和睡眠障碍的研究是广泛的， DT-LVAD接受者的一个重要临床结局没有跟上快速扩展的治疗方法的步伐， 适应症和MCS用于AHF护理的不断发展的技术进步。更好地了解LVAD的效果 对身体和心理症状的有效护理和支持LVAD患者至关重要 植入后。这项前瞻性同步混合方法研究的目的是描述 DT-LVAD后3个月AHF患者的客观和主观睡眠质量，并确定 睡眠质量的变化与认知功能、心理 症状和健康相关的生活质量。此外，该奖项将通过准备博士前实习生 先进的课程和直接的研究经验，混合方法的使用，重点分析 LVAD植入后观察到的症状变化，以及多次睡眠之间高度相关联系的发现 与AHF相关的症状调查结果将为以下方面提供基础知识： 建立新的AHF症状和症状管理科学研究项目。