Enhancing Research Capacity in Geriatric Palliative Care

描述(由申请人提供)：社会正面临其历史上最大的公共卫生挑战之一--老年人人口的增长和由于慢性严重疾病而导致的发病率增加。在接下来的几十年里，大多数医生将照顾患有多种合并症和长期患病的重病老年人。充足的证据 这表明，晚期疾病的特点通常是没有得到充分的治疗；护理系统支离破碎；医生、患者和家人之间的沟通不畅；家庭照顾者和支持系统的压力。在他们的报告《濒临死亡：改善临终关怀》中，医学研究所呼吁一支专家队伍为基于科学和实用的医学教育提供领导，并为严重和慢性病患者组织和开展临床、行为和健康服务研究。2006年，国家姑息治疗研究中心(NPCRC)在西奈山医学院成立，其使命是刺激、开发和资助旨在缓解痛苦症状并改善对重病患者、其家人和照顾者的护理的新研究。在过去的六年里，NPCRC已经成为提高我国医疗体系中病情最重和最脆弱患者的护理质量的运动的关键贡献者。我们已经建立了一个姑息治疗研究人员网络，他们正在解决我们最脆弱患者的最紧迫问题。在NPCRC取得成功的基础上，我们正通过R24机制寻求资金，通过NPCRC研究网络为早期研究人员创建研究技术援助计划，并通过支持试点/探索性项目和为经验丰富的研究人员开发合作研究，促进老年姑息治疗研究网络和多地点研究的发展，从而加强我们刺激重病老年人研究的努力。通过这些努力，我们的目标是确保所有卫生保健专业人员拥有知识和证据基础，为迅速增加的患有严重疾病的老年人提供高质量的姑息治疗。

DESCRIPTION (provided by applicant): Society is facing one of the largest public health challenges in its history - the growth of the population of older adults and increasing morbidity due to chronic serious illness. Over the next decades, most physicians will be caring for seriously ill elders with multiple comorbidities and lengthy duration of illness. Abundant evidence suggests that the advanced stages of disease are often characterized by inadequately treated physical distress; fragmented care systems; poor communication between doctors, patients, and families; and strains on family caregiver and support systems. In their report, Approaching Death: Improving Care at the End of Life, the Institute of Medicine called for a cadre of experts to supply leadership for scientifically- based and practically useful medical education and to organize and conduct clinical, behavioral, and health services research for patients with serious and chronic illness. In 2006, the National Palliative Care Research Center (NPCRC) was established at the Mount Sinai School of Medicine with a mission to stimulate, develop, and fund new research directed at providing relief from distressing symptoms and improving care for patients with serious illness, their families, and caregivers. Over the past six years, the NPCRC has emerged as a key contributor to the movement to improve quality of care for the sickest and most vulnerable patients in our nation's healthcare system. We have created a network of palliative care researchers who are addressing the most pressing problems of our most vulnerable patients. Building on the success of the NPCRC, we are seeking funding through this R24 mechanism to enhance our efforts to stimulate research for seriously ill older adults by creating a research technical assistance program for early- stage investigators through the NPCRC research network and catalyzing the development of research networks and multi-site studies in geriatric palliative care by supporting pilot/exploratory projects and the development of research collaborative for experienced investigators. Through these efforts, our goal is to ensure that all health care professionals have the knowledge and evidence base to provide high quality palliative care to the rapidly increasing numbers of older adults living with serious illnes.