Collaborative Pediatric Critical Care Research Network

 描述(由申请人提供)：协作性儿科重症监护研究网络(CPCCRN)是一个高效的研究网络，对于推进儿科重症监护医学的科学和实践至关重要。此次续签申请的总体目标是，韦恩州立大学(WSU)在马里兰州凯瑟琳·米特的领导下，继续作为CPCCRN的临床站点。米尔特博士在过去10年里一直在西斯安那州立大学CPCCRN工作，是一名儿科强化治疗师，拥有丰富的临床和转化性研究经验，并在CPCCRN的科学出版物方面有着既定的记录。此外，米尔特博士还展示了他在行为医学和传播学方面的研究专长。威斯康星州立大学作为临床站点的优势包括密歇根S儿童医院(CHM)，这是一家独立的、三级护理、学术性质的儿童S医院，提供全方位的儿科和外科专科服务。CHM的PICU是一个拥有38张床位的多学科病房，每年照顾1500名具有不同种族和民族背景的患者。超过85%的PICU患者在该机构内进行了随访。CHM是美国外科医生学会认证的1级儿科创伤中心，也是美国烧伤协会认证的烧伤中心。威斯康星州立大学的其他优势还包括其在联邦资助的多中心研究网络方面的丰富经验，如新生儿网络、青少年医学艾滋病毒/艾滋病干预试验网络、神经紧急情况治疗试验网络、儿科急救应用研究网络和儿童S肿瘤学小组。本申请中包含的概念提案建立在由Meert博士领导的先前CPCCRN研究的基础上，展示了在PICU中实现高质量的父母与临床医生沟通的许多挑战。对于健康素养较低的父母来说，高质量的沟通尤其重要，这是造成儿童健康差距的一个关键因素。以患者和家庭为中心的沟通(PFCC)可以改善沟通的质量，但在一定程度上取决于临床互动过程中父母的积极参与(例如，提问)。这一概念提案的目标是开发一种新的沟通干预措施--问题提示工具包；并确定干预措施可以在多大程度上加强PICU的PFCC，从而改善儿童和家庭结果。中心假设是，问题提示工具包的使用将增加父母在临床互动、知识、自我效能感和信任方面的积极参与，减少父母的焦虑，并最终有助于改善儿童与健康相关的生活质量 减轻了家庭负担，特别是对健康素养较低的家庭。这一假设将在追求两个具体目标的多中心研究中得到验证：(1)开发问题提示工具包，供危重儿童的父母使用；以及(2)确定在多大程度上 问题提示工具包可以在PICU中加强PFCC的使用，并改善儿童和家庭结果。这项提议意义重大，因为它将有助于一种新的沟通干预措施，可以应用于PICU实践，以满足父母的沟通需求并改善健康结果。

 DESCRIPTION (provided by applicant): The Collaborative Pediatric Critical Care Research Network (CPCCRN) is a highly productive research network that is essential to advancing the science and practice of pediatric critical care medicine. The overall aim of this renewal application is for Wayne State University (WSU), under the leadership of Kathleen Meert, MD, to continue as a clinical site in the CPCCRN. Dr. Meert, PI for the CPCCRN at WSU for the past 10 years, is a pediatric intensivist with a wealth of clinical and translational research experienc and an established track record of scientific publications for the CPCCRN. Additionally, Dr. Meert has demonstrated research expertise in behavioral medicine and communication science. Strengths of WSU as a clinical site include the Children s Hospital of Michigan (CHM), a free-standing, tertiary care, academic children s hospital offering the full spectrum of pediatric and surgical subspecialty services. The PICU at CHM is a 38-bed multidisciplinary unit that cares for >1500 patients/year with diverse racial and ethnic backgrounds. Over 85% of PICU patients have follow-up within the institution. CHM is an American College of Surgeons verified Level 1 Pediatric Trauma Center and an American Burn Association verified Burn Center. Additional strengths of WSU include its vast experience with federally-funded multicenter research networks such as the Neonatal Network, Adolescent Medicine Trials Network for HIV/AIDS Intervention, Neurological Emergencies Treatment Trials Network, Pediatric Emergency Care Applied Research Network, and the Children s Oncology Group. The concept proposal included in this application builds on prior CPCCRN research, led by Dr. Meert, demonstrating many challenges to achieving high quality parent-clinician communication in PICUs. High quality communication is especially important for parents with low health literacy, a key contributing factor to child health disparities. Patient- and family-centered communication (PFCC) may improve the quality of communication but depends, in part, on parents active participation (e.g., question asking) during clinical interactions. The objective of the concept proposal is to develop a novel communication intervention, the Question Prompt Toolkit; and determine the extent to which the intervention can enhance PFCC in PICUs, and thus improve child and family outcomes. The central hypothesis is that use of the Question Prompt Toolkit will increase parents active participation in clinical interactions, knowledge, self-efficacy and trust, reduce parent's anxiety, and ultimately contribute to better health-related quality of life for the child and reduced family burden, especially for families with low health literacy. The hypothesis will be tested in multicenter research that pursues 2 specific aims: (1) Develop the Question Prompt Toolkit for use among parents of critically-ill children; and (2) Determine the extent to which the Question Prompt Toolkit can enhance the use of PFCC in PICUs and improve child and family outcomes. The proposal is significant because it will contribute a new communication intervention that can be applied in PICU practice to address parents' communication needs and improve health outcomes.