Building and testing feasibility of EMPOWER, a skill-based psychosocial intervention for parents of critically ill children

项目摘要 在儿科重症监护病房（PICU）中生存严重的危及生命的疾病通常以 新的儿童发病率以及对儿童和父母心理健康的影响。父母在儿童的PICU中不可或缺 复苏然而，父母的心理健康和照顾者的自我效能感可能会受到显着的负面影响， 与儿童入住PICU相关的创伤，影响父母最佳帮助孩子的能力 恢复.认识到父母在儿童健康中的关键作用，美国国家医学院已经确定了一个 迫切需要对处于弱势状况的父母进行心理社会干预，如进入PICU。 然而，最近的一项系统综述发现，在PICU中缺乏家长干预。因此，迫切需要 为PICU父母提供有效的心理社会干预，减少PTSS并提高照顾者的能力。 出院后的自我效能感本提案的总体目标是获得构建和测试 通过以下三个具体目标进行理论驱动和循证父母心理社会干预的可行性： 目标1）建立授权，为儿童进入PICU的父母提供干预。亚吉拉医生会 与PICU利益相关者合作，并使用RE-AIM（范围，有效性，采用，实施和 维持）框架，以整合和调整现有家长干预措施的循证组成部分 创造力量。目标2）制定和测试一个培训课程，让家长辅导员能够提供 授权干预。成人学习的原则，教学法，角色扮演练习，以及 标准化情景干预将用于培训和测试家长导师的交付准备情况 干预。目标3）确定EMPOWER的可行性、可接受性和实施因素 干预家长导师将在可行性试验中向PICU家长提供干预措施。预期 这些目标的结果是一个可行的理论驱动和以证据为基础的干预措施，称为增强能力， 帮助父母获得技能，以减少直接的痛苦，我的概念模型假设，可以减少未来 PTSS和提高照顾者自我效能。预计这将通过改善父母的 支持孩子康复的能力，从而增加改善PICU儿童结局的潜力。这 K23提案还包括一个为期四年的培训计划。在导师专家团队的支持下， 作为顾问，Yagiela博士将获得制定行为干预措施，设计和开展临床 试验，定性和混合方法，并专业发展。培训目标将得以实现 通过与导师/顾问的频繁互动，教学课程，指导学习，研讨会， 两会这些K23支持的数据和培训将为未来R 01资助的 EMPOWER干预的随机对照试验，使Yagiela博士能够实现她的长期目标。 目标是成为一名独立的临床研究人员，开发，测试和实施心理社会学 改善父母和重症儿童身心健康状况的干预措施。

PROJECT SUMMARY Surviving a serious, life-threatening illness in the pediatric intensive care unit (PICU) often comes at the cost of new child morbidity and detriments to child and parent mental health. Parents are integral in a child’s PICU recovery. Yet, parent mental health and caregiver self-efficacy can be significantly and negatively impacted by the trauma associated with a child’s PICU admission, affecting parents’ ability to help their child optimally recover. Recognizing the key role of parents in child health, the National Academy of Medicine has identified a crucial need for psychosocial interventions for parents in vulnerable situations, such as PICU admission. However, a recent systematic review found a paucity of parent interventions in the PICU. Thus, a critical need exists for an effective psychosocial intervention for PICU parents that reduces PTSS and enhances caregiver self-efficacy after discharge. The overall objective of this proposal is to gain the skills to build and test the feasibility of a theory-driven and evidence-based parent psychosocial intervention through three specific aims: Aim 1) Build EMPOWER, an intervention for parents whose children are admitted to a PICU. Dr. Yagiela will collaborate with PICU stakeholders and use the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework to integrate and adapt evidence-based components from existing parent interventions to create EMPOWER. Aim 2) Develop and test a training curriculum to prepare parent mentors to deliver the EMPOWER intervention. Principles of adult learning, didactics, role-playing exercises, and delivery of the intervention in standardized scenarios will be used to train and test the readiness of parent mentors to deliver the intervention. Aim 3) Determine the feasibility, acceptability, and implementation factors of the EMPOWER intervention. Parent mentors will deliver the intervention to PICU parents in a feasibility trial. The expected outcome of these aims is a feasible theory-driven and evidence-based intervention called EMPOWER, that helps parents gain skills to reduce immediate distress, which my conceptual model posits can reduce future PTSS and enhance caregiver self-efficacy. This is expected to have a positive impact by improving parents’ ability to support their child’s recovery, thereby increasing the potential for improved PICU child outcomes. This K23 proposal also includes a four-year training plan. With the support of an expert team of mentors and advisors, Dr. Yagiela will gain training in developing behavioral interventions, designing and conducting clinical trials, and qualitative and mixed methods, and develop professionally. The training goals will be accomplished through frequent interaction with mentors / advisors, didactic coursework, mentored study, seminars, and conferences. This K23-supported data and training will provide a foundation for a future R01-funded randomized controlled trial of the EMPOWER intervention and enable Dr. Yagiela to achieve her long-term goal of becoming an independent clinician-researcher who develops, tests, and implements psychosocial interventions that improve mental and physical health outcomes in parents and critically ill children.