Symptom Management and Palliative Care Research in Adults with Advanced Disease

描述（由申请人提供）：T32博士前和博士后培训计划的申请描述了一个在晚期疾病（特别是癌症、心力衰竭和慢性危重病）成人中进行症状管理和姑息治疗研究的拟议培训计划。这个培训计划的长期目标是培养一个多元化的护理科学家群体，他们将促进我们对如何提供有效缓解的知识和理解-也就是说，症状的管理-显着损害晚期和不可治愈的疾病状态的生活质量。症状管理研究在患有限制生命的进行性疾病的受试者人群中尤其具有挑战性，但这些患者通常也最需要专家症状管理。除了针对单一症状（例如疼痛、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、严重疾病受试者缺失数据的可能性很高，以及在测量身体症状时解释共存抑郁和焦虑的影响是该人群的常见挑战。为了促进我们对症状管理方法的理解，并建立有效的姑息治疗所需的证据基础，进行性晚期疾病患者研究所需的方法学和分析策略的具体定制准备至关重要。本培训计划将满足这一需求。 该NRSA将在该计划的5年内为8名博士前学员和9名博士后学员提供支持。除了我们典型的申请人池，我们将特别针对BSN学生进入“快速通道”BSN到博士课程和少数群体的成员。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。我们的教师也有领导作用的国家专业组织与大型BSN成员，这些将提供额外的招聘机会。通过我们与几所拥有大量少数民族学生的学院的现有关系，我们将能够有针对性地招聘，以实现培训计划的人口平衡。我们已经与来自其他学科的各种有成就的研究人员建立了合作关系，他们将成为该培训计划的积极参与者。博士前和博士后培养计划 是建立在招聘和以前的毕业生生产力的成功记录，我们相信拟议的计划的重点将使学员作出重大贡献，护理科学的这一重要领域。

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.