Symptom Management and Palliative Care Research in Adults with Advanced Disease

描述(由申请者提供)：本申请T32博士后和博士后培训计划描述了一项在患有晚期疾病的成年人中进行症状管理和姑息治疗研究培训的拟议计划，特别是癌症、心力衰竭和慢性危重疾病。该培训计划的长期目标是培训不同群体的护士科学家，他们将增进我们对如何提供有效缓解--即症状管理--的知识和理解，这些症状会严重影响晚期和不治之症患者的生活质量。症状管理调查在患有限制生命的进展性疾病的受试者人群中尤其具有挑战性，但这些患者通常也是最需要专家症状管理的患者。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那里遗漏数据的可能性很高，以及在测量身体症状时考虑共存的抑郁和焦虑的影响，是这一人群中常见的挑战。为了促进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方面的具体定制准备是必不可少的。该培训计划将满足这一需求。NRSA将在5年的时间里为8名博士后实习生和9名博士后实习生提供支持。除了我们典型的申请者群体外，我们还将特别瞄准BSN学生和少数族裔群体成员，这些学生将进入BSN到博士课程的快速通道。我们有一个现有的内部计划，以确定我们学校有前途的BSN学生，他们表现出了直接进入博士课程的非凡潜力。我们的教员还在拥有大量BSN成员的国家专业组织中担任领导角色，这将提供更多的招聘机会。通过我们与几所拥有大量少数族裔学生的学院的现有关系，我们将能够有针对性地招生，以实现培训计划中的人口结构平衡。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，他们将成为本次培训计划的积极教员参与者。博士后和博士后培训计划 我们相信，拟议计划的重点将使学员能够为护理科学这一重要领域做出重大贡献。

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.