Quality of Mental Health Care in Assisted Living

描述（由申请人提供）：这是一个K 01指导研究科学家职业发展奖的申请。候选人是一名流行病学老年学家，他打算获得与卫生服务研究（HSR）领域相关的特定技能和知识。候选人的长期职业目标是成为一名成功的，高效的独立调查员，专注于流行病学和多种环境中老年人心理健康障碍的护理。在P. V. Rabins博士和C.G. Lyketsos，以及S.齐默尔曼，A. Rosenblatt，E. Stuart，N.城堡，M。布鲁斯和L.摩根，候选人将进行一个5年的职业发展计划。短期目标是：（1）通过开展一项前瞻性研究，重点关注辅助生活中的设施级精神卫生保健，获得实践领域和领导经验;（2）提高对HSR原则和方法以及老年人在卫生保健环境中的经验的认识;（3）在HSR仪器开发原则方面建立坚实的知识基础;（4）通过与相关领域的领导者的互动和合作，培养未来精神卫生服务研究工作的独立性;（5）培养负责任的研究行为。这些目标将通过教学培训（例如，约翰霍普金斯公共卫生学院的9门课程）、临床观察（例如，老年精神病学、门诊护理、长期护理）、结构化和非结构化网络（例如，与导师/合作者定期联系;出席会议;前往开展平行研究的地点）;以及开展研究项目。本研究的目的是：（1）开发一个以实证为基础的工具来测量辅助生活（AL）中精神卫生服务质量的设施级指标;（2）使用该工具来量化随机抽样的AL中的质量指标;（3）评估非痴呆症特定护理领域（NDSCA）和痴呆症特定护理领域（DSCA）之间质量指标的差异;以及（4）评估质量指标与试点样本中居民水平特征的关系，以确定未来R 01应用的效应量估计和方法。这些技能和经验的整合将为候选人提供在多层次因素背景下对精神卫生服务研究的深刻理解。相关性：精神障碍在急性白血病患者中非常普遍，并与许多不良结局相关，包括提前出院到疗养院和生活质量较差。随着越来越多的老年人与更大的精神病发病率利用这种护理环境，有显着的公共卫生问题的精神卫生保健质量。拟议的研究是关键和及时的，并将提供一个新的精神卫生保健质量工具，用于AL和实证数据的存在，以证据为基础的质量指标。

DESCRIPTION (provided by applicant): This is an application for a K01 Mentored Research Scientist Career Development Award. The candidate is an epidemiological gerontologist who proposes to acquire specific skills and knowledge related to the field of health services research (HSR). The candidate's long-term career goal is to become a successful, highly productive independent investigator focusing on the epidemiology and care of mental health disorders for elders in multiple settings. Under the mentorship of Drs. P.V. Rabins and C.G. Lyketsos, and the supervision of Drs. S. Zimmerman, A. Rosenblatt, E. Stuart, N. Castle, M. Bruce, and L. Morgan, the candidate will carry out a 5-year career development plan. Short-term goals are to (1) gain practical field and leadership experience by conducting a prospective study focused on facility-level mental health care in assisted living; (2) enhance knowledge of HSR principles and methods and of elders' experiences in health care settings; (3) develop a solid knowledge base in principles of HSR instrument development; (4) foster independence for future work in mental health services research through interactions and collaborations with leaders in related fields; and (5) train in the conduct of responsible research. These goals will be accomplished through didactic training (e.g. 9 courses at the Johns Hopkins School of Public Health); clinical observation (e.g. geriatric psychiatry, ambulatory care outpatient clinics, long-term care); structured and unstructured networking (e.g., regular contact with the mentors/collaborators; conference attendance; travel to sites conducting parallel research); and carrying out a research project. The aims of research project are to: (1) develop an evidence-based instrument to measure facility-level indicators of mental health care quality in assisted living (AL); (2) use the instrument to quantify quality indicators in a random sample of ALs; (3) evaluate differences in the presence of quality indicators between non-dementia-specific care areas (NDSCAs) and dementia-specific care areas (DSCAs); and (4) evaluate the relationship of quality indicators with resident- level characteristics in a pilot sample to ascertain effect size estimates and methods for a future R01 application. Integration of these skills and experiences will provide the candidate with a deep understanding of mental health services research in the context of multi-level factors. RELEVANCE: Mental disorders are highly prevalent in the AL setting and are associated with a number of adverse outcomes including early discharge to nursing homes and poorer quality of life. As more elders with greater psychiatric morbidity utilize this care setting, there are significant public health concerns about mental health care quality. The proposed research is both critical and timely and will provide a new mental health care quality instrument for use in AL and empirical data on presence of evidenced-based quality indicators.