Improving Anxiety Management and Rehabilitation Outcomes in Critical Care

描述(由申请人提供)：应聘者的研究兴趣包括开发和评估以患者为中心的治疗方法，旨在促进参与康复治疗，以便对患有危重疾病的成年人的心理和生活质量产生积极影响。她的短期职业目标是在物理医学和危重和受伤患者康复领域的领导者(李约瑟和韦格纳博士)的指导和专业知识的指导下进行研究。她的长期职业目标是成为一名独立的临床研究人员，进行以患者为导向的研究，专注于开发、评估和实施心理干预措施，以改善危重疾病后的短期和长期结果。为了实现这一事业 为了实现这一目标，候选人需要在几个关键领域接受额外的专门培训，以弥补其培训中的重要差距。通过导师指导、临床研究方法方面的重点课程工作、授予技巧研讨会和研究道德行为方面的培训，她将为成为一名独立的、以患者为导向的临床研究人员奠定坚实的基础。 在高级流行病学方法、研究设计和相关生物统计学方面的正式培训将通过以下方式进行：约翰霍普金斯大学彭博公共卫生学院(JHSPH)的教学课程工作；NIH赞助的随机行为临床试验夏季研究所；为期5天的康复研究拨款编写强化研讨会；出席年度科学会议并发表报告；以及出席每月举行的约翰霍普金斯物理医学和康复大赛。此外，这种学习将作为与Needham和Wegener博士的定期指导会议的一部分得到加强和应用，他们在候选人研究领域的临床研究方法方面具有相关的专业知识和经验。候选人还将有机会接触到更多的流行病学和生物统计学教员，他们是李约瑟博士危重疾病和手术后结果(OACIS)研究组的一部分。 为了改善重症监护病房中参加早期康复治疗的危重患者的焦虑管理，候选人计划进行一项由心理学家管理的新型干预措施的随机对照双盲试点试验。这项研究的总体目标是改善参与早期康复治疗的危重患者的焦虑管理。焦虑症状和目前的ICU焦虑管理策略可能与出院后较差的心理结果有关。评估ICU中焦虑症状的不良影响，以及一种新的焦虑管理干预措施的潜在好处，对于改善患者的预后是创新和重要的。拟议研究涵盖的科学学科和研究领域将是多学科的，包括物理医学和康复、康复心理学、危重护理和肺部医学、物理治疗、职业治疗和护理专业。

DESCRIPTION (provided by applicant): The candidate's research interests encompass developing and evaluating patient-centered treatment approaches designed to facilitate engagement in rehabilitation therapies, in order to positively affect psychological and quality of life outcomes in adults surviving critical illness. Her short-term career goal is to conduct mentored research with guidance and expertise provided by leaders in the field of physical medicine and rehabilitation for critically ill and injured patients (Drs. Needham and Wegener). Her long-term career goal is to become an independent clinical researcher conducting patient-oriented research that is focused on developing, evaluating, and implementing psychological interventions to improve short- and long-term outcomes after critical illness. To reach this career goal, the candidate needs additional specialized training in several key areas to address important gaps in her training. Through mentorship, focused coursework in clinical research methods, grantsmanship workshops, and training in the ethical conduct of research, she will develop a solid foundation to build her career as an independent, patient-oriented clinical researcher. Formal training in advanced epidemiological methods, study design, and associated biostatistics will occur through didactic course work at the Johns Hopkins Bloomberg School of Public Health (JHSPH); an NIH-sponsored summer institute on Randomized Behavioral Clinical Trials; a 5-day intensive workshop on grant writing for rehabilitation research; attendance and presentations at annual scientific conferences; and attendance at the monthly Johns Hopkins Physical Medicine and Rehabilitation grand rounds. In addition, this learning will be reinforced and applied as part of regular mentoring meetings with Drs. Needham and Wegener who have relevant expertise and experience in clinical research methods in the candidate's field of study. The candidate will also have access to additional epidemiology and biostatistics faculty members who are part of Dr. Needham's Outcomes after Critical Illness and Surgery (OACIS) Research group. To improve anxiety management in critically ill patients participating in early rehabilitation therapies in the intensive care unit, the candidate plans to conduct a randomized controlled double-blinded pilot trial of a novel psychologist-administered intervention. The overall goal of this research is to improve the management of anxiety in critically ill patients participating in early rehabilitation therapies. Symptoms of anxiety, and current ICU anxiety management strategies, may be associated with worse psychological outcomes after hospital discharge. Evaluating the adverse effects of anxiety symptoms in the ICU, and the potential benefits of a novel anxiety management intervention is innovative and important for improving patient outcomes. The scientific disciplines and research areas encompassed by the proposed study will be multidisciplinary to include physical medicine and rehabilitation, rehabilitation psycholog, critical care and pulmonary medicine, physical therapy, occupational therapy, and nursing care specialties.