Communication Quality and Patient Outcomes in HIV/AIDS and Substance Abuse

艾滋病毒/艾滋病和药物滥用方面的沟通质量和患者结果

• 批准号: 9000684
• 负责人: MARY CATHERINE BEACH
• 金额: $ 18.47万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9000684
• 关键词: AIDS/HIV problem; Address; Adherence; Anti-Retroviral Agents; Attention; Award; Caring; Clinical; Clinical Research; Communication; Counseling; Day Care; Discourse analysis; Drug abuse; Drug usage; Epidemiologic Studies; Faculty; Goals; HIV; Health; Health Professional; Healthcare; High Prevalence; Internal Medicine; Lead; Life; Logic; Medical; Medicine; Mentors; Mentorship; Mid-Career Clinical Scientist Award (K24); Midcareer Investigator Award in Patient-Oriented Research; Mining; Oral cavity; Outcome; Patient-Focused Outcomes; Patients; Pattern; Perception; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pharmacotherapy; Physicians; Population; Postdoctoral Fellow; Prevention Research; Professional counselor; Provider; Qualitative Research; Quality of Care; Recommendation; Recovery; Reporting; Research; Research Personnel; Sampling; Scholarship; Students; Substance abuse problem; Techniques; Therapeutic; Thinking; Time; Training; Treatment outcome; Twin Multiple Birth; Universities; Visit; Work; behavior change; career; evidence base; experience; health care quality; improved; medical schools; mid-career faculty; mindfulness; motivational enhancement therapy; patient oriented research; programs; sociolinguistics; substance abuse treatment; systematic review

 DESCRIPTION (provided by applicant): This is a proposal for a K24 Midcareer Investigator Award in Patient-oriented Research for Mary Catherine Beach, MD, MPH of the Johns Hopkins University School of Medicine. Dr. Beach is an Associate Professor of Medicine in the Division of General Internal Medicine and Core Faculty in the Welch Center for Prevention, Epidemiology and Clinical Research. Dr. Beach has spent the majority of her career and scholarship over the past 10 years focusing on patient-oriented research in populations with a high prevalence of substance abuse (or perception of substance abuse) that negatively impacts quality of care and health outcomes. Despite a well- established evidence base that high-quality respectful patient-clinician communication and relationships are critically important to patient outcomes, there are wide gaps in our current understanding of patient-clinician communication in the treatment of HIV/AIDS and drug abuse. One recent systematic review determined that therapeutic alliance between patient and counselor was most important in predicting drug treatment outcomes but little is known about how a therapeutic alliance is built in medical settings between physicians and patients with active drug use. This K24 award will protect time for the applicant to mentor junior investigators and conduct significant original research aimed at improving communication and relationships between clinicians and patients with substance abuse. The aims of the original research are: (1) to explore the quality of provider counseling about substance abuse treatment within routine ambulatory primary HIV care encounters, identify reasons for missed opportunities for counseling, identify correlates of higher quality counseling, and prioritize recommendations for provider training, (2) To discover, using the sociolinguistic technique of conversation analysis, which patterns of asking about and addressing anti-retroviral adherence are most reliable and effective in clinical encounters among HIV-infected patients with substance abuse, and (3) to analyze the vocal tone on a sample of audio-recorded encounters and examine whether higher levels of respectfulness and warmth as rated by independent observers predict continued patient engagement in care among HIV-infected patients with substance abuse. These aims will be addressed in the context of providing mentorship to new and existing junior faculty, post-doctoral fellows and students. The K24 will allow Dr. Beach to more effectively pursue her long-term career goals to enhance respect, to improve communication, and to better the patients' experiences, all for the purpose of reducing suffering and improving health and well-being of these underserved and stigmatized populations.

 描述（由申请人提供）：这是为约翰·霍普金斯大学医学院的玛丽·凯瑟琳·比奇（Mary Catherine Beach）医学博士、公共卫生硕士申请 K24 职业生涯中期研究员奖以患者为导向的研究的提案。 Beach 博士是韦尔奇预防、流行病学和临床研究中心普通内科医学部的医学副教授和核心教员。过去 10 年，Beach 博士将其职业生涯和学术生涯的大部分时间都花在了以患者为导向的研究上，对象是药物滥用（或对药物滥用的看法）发生率较高的人群，这些药物滥用会对护理质量和健康结果产生负面影响。尽管有充分的证据表明，高质量的相互尊重的患者与临床医生的沟通和关系对于患者的治疗结果至关重要，但我们目前对治疗艾滋病毒/艾滋病和药物滥用方面的患者与临床医生的沟通的理解存在很大差距。最近的一项系统综述确定，患者和咨询师之间的治疗联盟对于预测药物治疗结果最为重要，但对于如何在医疗环境中医生和积极使用药物的患者之间建立治疗联盟知之甚少。该 K24 奖项将保护申请人有时间指导初级研究人员并开展旨在实现以下目标的重要原创研究： 改善临床医生和药物滥用患者之间的沟通和关系。最初研究的目的是：(1) 探索在常规流动初级艾滋病毒护理中提供者关于药物滥用治疗的咨询质量，确定错过咨询机会的原因，确定高质量咨询的相关因素，并优先考虑提供者培训的建议，(2) 使用对话分析的社会语言学技术，发现哪种询问和解决抗逆转录病毒依从性问题的模式在临床中最可靠和最有效 (3) 分析艾滋病毒感染者与药物滥用者之间的接触情况，以及（3）分析音频记录的接触样本中的语气，并检查独立观察员评价的较高程度的尊重和热情是否预示着患者会继续参与艾滋病毒感染者与药物滥用者的护理。这些目标将在为新的和现有的初级教师、博士后研究员和学生提供指导的背景下得到实现。 K24 将使 Beach 医生能够更有效地追求她的长期职业目标，以增强尊重、改善沟通并改善患者的体验，所有这些都是为了减少这些服务不足和受到污名化人群的痛苦并改善他们的健康和福祉。