Progressive Muscle Relaxation for Chronic Pain in an Acute Care Setting

项目摘要/摘要 这个拟议项目的总体目标是：1)将米娅·米宁医生培养成一名综合性疼痛研究人员 和补充健康，具有进行独立多学科研究的技能；以及2)进行 评估放松干预治疗偏头痛的可行性和可接受性的临床研究 到急诊科就诊的病人。Minen博士将发展和提升她的知识 通过有指导的培训，在5个关键领域提供基础、经验和技能：1)身心干预(MBI) 技术；2)先进的研究方法(在卫生服务、临床试验和移动卫生战略方面)；3) 急诊医学疼痛研究方法和负责任的行为；4)新研究设计 框架；以及5)预防科学、方案干预发展和比较有效性 研究。研究性培训的长期目标是能够独立开发、评估、提炼、 并将新的和现有的基于证据的mbi用于不同医学专业的偏头痛患者与 特别关注急诊医疗和初级保健环境。此外，培训的目的是 获得单独研究MBIS以及与营养食品和药物联合研究的高级技能。这个 在K23应用中提出的研究对于理解以证据为基础的mbi是多么重要。 使急性护理环境中的慢性疼痛患者更容易获得。它有助于为以下方面设置框架 将基于证据的mbi转化为其他医疗环境中的使用。偏头痛，慢性疼痛的情况是 作为研究的范例，是一个重大的公共卫生问题。偏头痛影响着3000多万美国人， 这被认为是最令人丧失能力的情况之一。它负责相当数量的 美国急诊室每年有500万次令人头痛的就诊。本研究的目的是研究进行性肌肉的使用。 向急诊科就诊的偏头痛患者的放松，一种MBI。在研究期间，我们 将使用患者反馈来优化智能手机应用程序(应用程序)RELAXaHEAD，这是一款带有PMR和 每日头痛日记。然后，我们会就放宽方法进行可行性和可接受性研究(使用 RELAXAHEAD和流产的偏头痛止痛药)。这项研究的结果将为未来的R01 申请为向急诊室就诊的偏头痛患者进行大规模的MBI试验。建议数 研究和培训将在纽约大学朗格尼医学中心的ED进行。米南医生的 指导和咨询团队包括一个由MBI和行为研究专家组成的跨学科团队， 流动卫生、头痛医学、急诊医学、定性和混合方法研究、人口 健康和统计数据。拟议的研究和培训计划将为Minen博士提供坚实的基础 作为一家独立资助的临床研究机构，致力于单独使用MBIS和联合使用 营养食品和药物，以改善急性护理环境中慢性疼痛患者的护理。

PROJECT SUMMARY/ABSTRACT The overall goals of this proposed project are 1) to develop Dr. Mia Minen into a pain researcher in integrative and complementary health with skills to conduct independent multidisciplinary research; and 2) to conduct a clinical research study to assess the feasibility and acceptability of a relaxation intervention for migraine patients who present to the emergency department (ED). Dr. Minen will develop and advance her knowledge base, experience, and skills in 5 key areas through mentored training: 1) Mind-body intervention (MBI) techniques; 2) Advanced research methods (in health services, clinical trials, and mobile health strategies); 3) Emergency medicine pain research methodology and responsible conduct; 4) New research design frameworks; and 5) Prevention science, program intervention development, and comparative effectiveness research. The long-term goal of the research training is to be able to independently develop, assess, refine, and compare novel and existing evidence-based MBIs for migraine patients across medical specialties, with a special focus on the emergency medicine and primary care settings. In addition, the purpose of the training is to gain advanced skills to study the MBIs alone and in combination with nutraceuticals and medications. The research proposed in this K23 application is important to understanding how evidence-based MBIs can be made more accessible for chronic pain patients in the acute care setting. It helps to set the framework for translating evidence-based MBIs into use in other medical settings. Migraine, the chronic pain condition being used as an example for study, is a significant public health issue. Migraine affects over 30 million Americans, and it is considered to be one of the most disabling conditions. It is responsible for a substantial number of the five million headache visits/year to US EDs. The purpose of this research is to study use of progressive muscle relaxation, a MBI, in patients with migraine who present to the emergency department. During the study, we will use patient feedback to optimize the smartphone application (app) RELAXaHEAD, an app with PMR and a daily headache diary. We will then conduct a feasibility and acceptability study of the RELAX approach (use of RELAXaHEAD and abortive migraine pain medication). The results of this research will inform a future R01 application to conduct a large-scale trial of MBI for migraine patients who present to the ED. The proposed research and training will be conducted at New York University Langone Medical Center's ED. Dr. Minen's mentorship and advisory team includes an interdisciplinary team with experts in MBI and behavioral research, mobile health, headache medicine, emergency medicine, qualitative and mixed methods research, population health, and statistics. The proposed research and training plans will provide a strong foundation for Dr. Minen as an independently funded clinical investigator dedicated to using MBIs alone and in combination with nutraceuticals and medications to improve the care of chronic pain patients in the acute care setting.