Enhancing Research Capacity in Geriatric Palliative Care

描述（由申请人提供）：社会正面临着历史上最大的公共卫生挑战之一-老年人人口的增长和慢性严重疾病导致的发病率增加。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疾病持续时间长的重病老人。大量证据 表明，疾病的晚期往往表现为治疗不当的身体痛苦;支离破碎的护理系统;医生，患者和家庭之间的沟通不畅;家庭照顾者和支持系统的压力。在他们的报告《接近死亡：改善生命末期的护理》中，医学研究所呼吁建立一个专家骨干队伍，为有科学依据和实用的医学教育提供领导，并为严重和慢性疾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，发展和资助新的研究，旨在缓解痛苦症状，改善对严重疾病患者，他们的家人和护理人员的护理。在过去的六年里，NPCRC已经成为提高我国医疗系统中最严重和最脆弱患者护理质量的关键贡献者。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。在全国人大常委会成功的基础上，我们正在通过这一R24机制寻求资金，以加强我们的努力，刺激重病老年人的研究，通过NPCRC研究网络为早期研究人员创建一个研究技术援助计划，并通过支持试点/探索性项目和为有经验的研究人员开展研究合作。通过这些努力，我们的目标是确保所有卫生保健专业人员都有知识和证据基础，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.