Symptom Management and Palliative Care Research in Adults with Advanced Disease

描述（由申请人提供）：这是T32博士前和博士后培训计划的申请，描述了一个针对晚期疾病（特别是癌症、心力衰竭和慢性危重疾病）成人的症状管理和姑息治疗研究的拟议培训计划。这个培训项目的长期目标是培养一个多样化的护理科学家群体，他们将提高我们的知识和理解，如何提供有效的姑息治疗，即对严重损害晚期和不治之症患者生活质量的症状进行管理。症状管理调查尤其具有挑战性的受试者人群谁有生命限制，进展性疾病，但这些患者通常也是最需要专家症状管理。除了针对单一症状（如疼痛、呼吸困难）的测量和仪器问题外，在疾病进展的背景下确定适当的终点，从病情严重的受试者中丢失数据的可能性很高，以及在测量身体症状时考虑共存的抑郁和焦虑的影响，这些都是这一人群的共同挑战。为了提高我们对症状管理方法的理解，并建立有效姑息治疗所需的证据基础，对进展性晚期疾病患者进行研究所需的方法和分析策略进行专门的定制准备是必不可少的。这个培训项目将满足这一需求。该计划将在5年内为8名博士预科生和9名博士后培训生提供支持。除了我们的典型申请群体，我们将特别针对BSN学生进入“快速通道”BSN到博士项目和少数群体的成员。我们有一个现有的内部计划，以确定有前途的BSN学生在我们学校谁表现出特殊的潜力，直接进入博士课程。我们的教师还在拥有大量BSN会员的国家专业组织中担任领导角色，这将提供额外的招聘机会。通过我们与几所拥有大量少数族裔学生的大学的现有关系，我们将能够针对招聘目标，在培训计划中实现人口平衡。我们已经与来自其他学科的许多有成就的研究人员建立了合作关系，他们将积极参与这个培训项目。前、博士后培养计划

DESCRIPTION (provided by applicant): This application for a T32 predoctoral and postdoctoral training program describes a proposed plan for training in symptom management and palliative care research among adults with advanced disease - specifically cancer, heart failure, and chronic critical illness. The long-term goal of this training program is to train a diverse group nurse scientists who will advance our knowledge and understanding of how to provide effective palliation - - that is, management of symptoms - - that significantly impair quality of life in advanced and incurable disease states. Symptom management investigations are especially challenging in subject populations who have life-limiting, progressive disease, yet these are also the patients usually in greatest need of expert symptom management. In addition to measurement and instrument issues specific to single symptoms (e.g. pain, dyspnea), identifying appropriate end points in the context of disease progression, the high likelihood of missing data from subjects who are quite ill, and accounting for the effects of co-existing depression and anxiety when measuring physical symptoms are common challenges in this population. In order to advance our understanding of symptom management approaches and build the evidence base needed for effective palliative care, specific tailored preparation in methodologies and analytic strategies needed for research with persons with progressive, advanced illness are essential. This training program will address that need. This NRSA will provide support for 8 predoctoral trainees and 9 post-doctoral trainees over the 5 years of the program. In addition to our typical applicant pool, we will particularly target BSN students for entry to the "fast-track" BSN-to-PhD program and members of minority groups. We have an existing internal program to identify promising BSN students in our school who demonstrate exceptional potential for moving directly in to a doctoral program. Our faculty also have leadership roles in national specialty organizations with large BSN memberships, and these will provide additional recruitment opportunities. Through our existing relationships with several colleges that have large minority student populations, we will be able to target recruitment to achieve a demographic balance in the training program. We have established collaborative relationships with a variety of accomplished researchers from other disciplines who will be active faculty participants on this training program. Both the pre- and postdoctoral training plans are built on a successful record of recruitment and productivity of previous graduates and we believe the focus of the proposed program will enable trainees to make significant contributions to this important area of nursing science.