Understanding and Improving Surgical Decision-Making for Persons Living with Dementia, their Family Caregivers, and their Providers: A Mixed Methods Study
了解和改善痴呆症患者、其家庭护理人员及其提供者的手术决策:一项混合方法研究
基本信息
- 批准号:10595437
- 负责人:
- 金额:$ 29.22万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-05-01 至 2025-04-30
- 项目状态:未结题
- 来源:
- 关键词:AddressAlzheimer&aposs DiseaseAlzheimer&aposs disease related dementiaAmbulatory Surgical ProceduresAreaAwardAwarenessBenignBlood VesselsBudgetsCaregiversCaringCase StudyCholecystectomyClinicalColectomyConsensusDataDecision MakingDementiaElderlyEmergency SituationEpidemiologyFamily CaregiverFundingGoalsHealthHealth systemHip FracturesInterviewInvestigationInvestmentsLinkMalignant NeoplasmsMedicalMedicareMethodsObstructionOperating RoomsOperative Surgical ProceduresOrthopedic ProceduresOutcomeOutpatientsParentsPatient-Centered CarePatient-Focused OutcomesPatientsPeer ReviewPersonsPoliciesPopulationProceduresProcessProviderQuality of lifeRecommendationRecoveryResearchResearch InfrastructureResearch PriorityRiskSpecific qualifier valueSurgeonTimeTrainingUnited States National Institutes of HealthVulnerable PopulationsWorkacute carebasecomparativecostdesignevidence baseevidence based guidelinesexperienceimprovedinformantinterestknee replacement arthroplastymalignant breast neoplasmmortalityoperationpost-operative rehabilitationpreservationrecruitsurgery outcome
项目摘要
Project Summary/Abstract (30 lines max)
Our project, R01AG067507: “Understanding and Improving Surgical Decision-Making for Persons Living
with Dementia, their Family Caregivers, and their Providers: A Mixed Methods Study”, has made great
progress toward our goals. As per the criteria of PA-20-272, this proposed work will "increase and preserve
the parent award’s overall impact " by "achieving certain new research objectives… within the original scope of
the peer reviewed and approved project." We have identified four areas of investigation that would benefit
from supplemental funding:
1) The need for evidence on outcomes for surgeries in addition to ones specified in the original project.
2) The need to investigate surgery taking place in outpatient settings including Ambulatory Surgery Centers.
3) The need to investigate medical (non-surgical) alternatives for patients who are eligible for surgery yet
prefer not to proceed.
4) The need to examine longer term outcomes, such as 4-5 year survival, with more current data.
We therefore propose to supplement our current project to understand the epidemiology of surgery for
PLWDs, as well as patient, caregiver, and provider practices and challenges of surgical decision-making in
clinical settings.
Supplemental Aim 1) Develop the evidence base to understand comparative outcomes of surgery
provided to PLWDs. We will use Medicare data to: 1) describe the epidemiology of surgery for PLWDs for
selected elective major cancer (e.g., breast cancer) and non-cancer surgery (e.g., colectomy for benign
conditions, cholecystectomy), and analyze the association of dementia status with outcomes, including 5 year
survival and Excess Days in Acute Care (EDAC); 2) Compare outcomes among alternative surgical
interventions; and 3) Track outcomes for patients with and without surgery.
Supplemental Aim 2) Characterize surgical decision-making for PLWDs in clinical settings for the surgical
situations described in Supplemental Aim 1.
Supplemental Aim 3) We will supplement our modified Delphi panel to consider the situations described in
Supplemental Aim 1.
Impact. Results of this supplemental work will greatly increase the impact of the current project using the
currently funded research infrastructure. Our study will support key advancements in ADRD research by
focusing on under-studied areas of surgical decision-making. Our Aims are linked but not conditional, and
results from Aims 1 and 2 will inform the Delphi panel. Our work also will address other NIH research priorities
including barriers faced by vulnerable populations, goals of care, and better decision-making.
项目摘要/摘要(最多30行)
我们的项目,R 01 AG 067507:“了解和改善生活在美国的人的手术决策”
与痴呆症,他们的家庭照顾者和他们的提供者:一项混合方法研究”,已经取得了很大的进展,
朝着我们的目标前进。根据PA-20-272的标准,这项拟议工作将“增加和保留
在原有的研究范围内,通过实现某些新的研究目标,
同行评审和批准的项目。“我们已经确定了四个调查领域,
补充资金:
1)除了原始项目中规定的手术外,还需要手术结局的证据。
2)需要调查在门诊环境中进行的手术,包括门诊手术中心。
3)需要为符合手术条件的患者研究医疗(非手术)替代方案
我不想继续了
4)需要用更多的最新数据检查更长期的结果,如4-5年生存率。
因此,我们建议补充我们目前的项目,以了解外科手术的流行病学,
PLWD,以及患者,护理人员和提供者的手术决策实践和挑战,
临床环境。
补充目标1)开发证据基础,以了解手术的比较结局
提供给艾滋病毒携带者。我们将使用医疗保险数据:1)描述PLWD手术的流行病学,
选择的选择性主要癌症(例如,乳腺癌)和非癌症手术(例如,结肠良性切除术
条件、胆囊切除术),并分析痴呆状态与结局(包括5年)的相关性
生存率和急性护理中的剩余天数(EDAC); 2)比较替代手术治疗的结果
干预; 3)跟踪手术和非手术患者的结局。
补充目标2)描述PLWD在临床环境中的手术决策,
补充目标1中描述的情况。
补充目标3)我们将补充修改后的德尔菲面板,以考虑
补充目标1.
冲击这项补充工作的结果将大大增加目前项目的影响,
目前,研究基础设施。我们的研究将支持ADRD研究的关键进展,
专注于研究不足的外科决策领域。我们的目标是相互联系的,但不是有条件的,
目标1和2的结果将通知德尔菲小组。我们的工作也将解决其他NIH研究的优先事项
包括弱势群体面临的障碍、护理目标和更好的决策。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Joel S. Weissman其他文献
MP32-08 ACCOUNTABLE CARE ORGANIZATIONS AND THE USE OF PROSTATE CANCER SCREENING
- DOI:
10.1016/j.juro.2017.02.983 - 发表时间:
2017-04-01 - 期刊:
- 影响因子:
- 作者:
Christian P. Meyer;Anna Krasnova;Jesse D. Sammon;Philipp Gild;Nicolas von Landenberg;Stuart R. Lipsitz;Joel S. Weissman;Felix K.H. Chun;Margit Fisch;Maxine Sun;Quoc-Dien Trinh - 通讯作者:
Quoc-Dien Trinh
Understanding the Roles, Responsibilities, and Factors for Success of Health Equity Officers in Health Care Settings: A Qualitative Study
了解卫生保健机构中健康公平官员的角色、责任和成功因素:定性研究
- DOI:
- 发表时间:
2024 - 期刊:
- 影响因子:3.3
- 作者:
Rachel R. Adler;Alysa Pomer;Saathvika Diviti;Joy A Lewis;Aswita Tan;Joel S. Weissman - 通讯作者:
Joel S. Weissman
Patients with dementia or frailty undergoing major limb amputation have poor outcomes
患有痴呆症或身体虚弱的患者接受大肢体截肢后预后较差。
- DOI:
10.1016/j.jvs.2024.08.058 - 发表时间:
2025-01-01 - 期刊:
- 影响因子:3.600
- 作者:
Samir K. Shah;Lingwei Xiang;Rachel R. Adler;Clancy J. Clark;John Hsu;Susan L. Mitchell;Emily Finlayson;Dae Hyun Kim;Kueiyu Joshua Lin;Joel S. Weissman - 通讯作者:
Joel S. Weissman
The impact of patient socioeconomic status and other social factors on readmission: a prospective study in four Massachusetts hospitals.
患者社会经济状况和其他社会因素对再入院的影响:在马萨诸塞州四家医院进行的一项前瞻性研究。
- DOI:
- 发表时间:
1994 - 期刊:
- 影响因子:0
- 作者:
Joel S. Weissman;Robert S. Stern;Arnold M. Epstein - 通讯作者:
Arnold M. Epstein
Should obtaining a preoperative audiogram before tympanostomy tube placement be used as a quality metric? A survey of pediatric otolaryngologists
- DOI:
10.1016/j.ijporl.2016.06.004 - 发表时间:
2016-09-01 - 期刊:
- 影响因子:
- 作者:
Nikhila Raol;Christopher J. Hartnick;Joel S. Weissman - 通讯作者:
Joel S. Weissman
Joel S. Weissman的其他文献
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{{ truncateString('Joel S. Weissman', 18)}}的其他基金
Understanding and Improving Surgical Decision-Making for Persons Living with Dementia, their Family Caregivers, and their Providers: A Mixed Methods Study
了解和改善痴呆症患者、其家庭护理人员及其提供者的手术决策:一项混合方法研究
- 批准号:
10405060 - 财政年份:2020
- 资助金额:
$ 29.22万 - 项目类别:
Understanding and Improving Surgical Decision-Making for Persons Living with Dementia, their Family Caregivers, and their Providers: A Mixed Methods Study
了解和改善痴呆症患者、其家庭护理人员及其提供者的手术决策:一项混合方法研究
- 批准号:
9973606 - 财政年份:2020
- 资助金额:
$ 29.22万 - 项目类别:
Understanding and Improving Surgical Decision-Making for Persons Living with Dementia, their Family Caregivers, and their Providers: A Mixed Methods Study
了解和改善痴呆症患者、其家庭护理人员及其提供者的手术决策:一项混合方法研究
- 批准号:
10848596 - 财政年份:2020
- 资助金额:
$ 29.22万 - 项目类别:
Understanding and Improving Surgical Decision-Making for Persons Living with Dementia, their Family Caregivers, and their Providers: A Mixed Methods Study
了解和改善痴呆症患者、其家庭护理人员及其提供者的手术决策:一项混合方法研究
- 批准号:
10589248 - 财政年份:2020
- 资助金额:
$ 29.22万 - 项目类别:
Understanding and Improving Surgical Decision-Making for Persons Living with Dementia, their Family Caregivers, and their Providers: A Mixed Methods Study
了解和改善痴呆症患者、其家庭护理人员及其提供者的手术决策:一项混合方法研究
- 批准号:
10617273 - 财政年份:2020
- 资助金额:
$ 29.22万 - 项目类别:
Identifying barriers, facilitators and outcomes of Advanced Care Planning conversations with Medicare patients
确定与 Medicare 患者进行高级护理计划对话的障碍、促进因素和结果
- 批准号:
9763016 - 财政年份:2017
- 资助金额:
$ 29.22万 - 项目类别:
Advance Care Planning (ACP) among Sexual and Gender Minority Individuals and Their Caregivers
性少数群体及其护理人员的预先护理计划 (ACP)
- 批准号:
10093464 - 财政年份:2017
- 资助金额:
$ 29.22万 - 项目类别:
Post-Trial Access for Insured and Uninsured Participants
投保和未投保参与者的试验后访问
- 批准号:
7127726 - 财政年份:2005
- 资助金额:
$ 29.22万 - 项目类别:
Post-Trial Access for Insured and Uninsured Participants
投保和未投保参与者的试验后访问
- 批准号:
7272821 - 财政年份:2005
- 资助金额:
$ 29.22万 - 项目类别:
Post-Trial Access for Insured and Uninsured Participants
投保和未投保参与者的试验后访问
- 批准号:
7034003 - 财政年份:2005
- 资助金额:
$ 29.22万 - 项目类别: