Assessing Barriers to Self-Management if Comorbidities

描述（由申请人提供）：候选人：Bayliss博士是科罗拉多Kaiser Permanente（KPCO）的临床研究员和科罗拉多大学健康科学中心的助理教授。她是一位经验丰富的家庭医生，并完成了初级保健研究奖学金和MSPH学位。她已经进行了初步的有前途的工作，对自我保健的障碍，为患有多种慢性疾病的人，和共病的医疗条件对身体功能的影响。她的长期目标是通过以下方式为患有多种慢性疾病的人的护理提供循证建议：确定与这一人群护理过程相关的问题;设计实用工具和干预措施以改善这一过程;并鼓励提供者和政策制定者调查专用疾病模型的替代方案。环境：Bayliss博士在KPCO的临床研究部门（CRU）工作。CRU由90多名工作人员和研究人员组成，致力于开展高质量的研究并将其转化为实践。她的主要导师是KPCO的高级科学家和慢性病自我护理领域的国际专家Russell格拉斯哥博士。她与她的指导团队的其他成员有着额外的牢固的工作关系，这些成员在卫生服务研究，调查开发，心理测量学，药物依从性和翻译方面都有专业知识。 研究付诸实践。研究：对患有多种疾病的人的护理是一个关键的国家卫生保健问题，也是AHRQ的优先事项。慢性病患者的成功结果在很大程度上取决于自我管理。这一群体自我管理的障碍没有得到很好的界定。我们正在编制一份问卷，以评估患有多种慢性病的人自我管理的障碍。本提案的目标是对该问卷进行试点测试和验证;通过KPCO在5个重要研究人群中进行管理;将其修订为实用的临床有用工具;并开始在临床竞技场中实施。一个有效和可靠的工具来评估自我管理的障碍将奠定基础，临床干预措施，以解决这些障碍，改善健康结果。

DESCRIPTION (provided by the applicant): The candidate: Dr. Bayliss is a Clinician Investigator at Kaiser Permanente, Colorado (KPCO) and Assistant Professor at the University of Colorado Health Sciences Center. She is an experienced family physician and has completed a primary care research fellowship and MSPH degree. She has conducted initial promising work on barriers to self-care for persons with multiple chronic medical conditions, and the impact of comorbid medical conditions on physical functioning. Her long term goals are to generate evidence-based recommendations for the care of persons with multiple chronic medical conditions by: Identifying issues relevant to the process of care for this population; designing practical tools and interventions to improve this process; and encouraging providers and policy makers to investigate alternatives to exclusive use of disease-specific models. The Environment: Dr. Bayliss is based at KPCO in the Clinical Research Unit (CRU). The CRU consists of over 90 staff and investigators devoted to conducting and translating high quality research into practice. Her primary mentor is Dr. Russell Glasgow, a Senior Scientist at KPCO and an international expert in the field of self-care for chronic disease. She has additional strong working relationships with other members of her mentoring team who have combined expertise in health services research, survey development, psychometrics, medication adherence, and translation of research into practice. The Research: The care of persons with multiple medical conditions is a critical national health care issue and an AHRQ priority. Successful outcomes for persons with chronic conditions depend heavily on self-management. Barriers to self-management for this population are not well defined. We are developing a questionnaire to assess barriers to self-management for persons with multiple chronic conditions. The goal of this proposal is to pilot test and validate this questionnaire; administer it in 5 important study populations available through KPCO; revise it into a practical, clinically useful tool; and begin to implement it in the clinical arena. A valid and reliable instrument to assess barriers to self management will lay the groundwork for clinical interventions to address these barriers and improve health outcomes.