Doctoral Dissertation Research: A Syndrome of Care: The New Sciences of Survivorship at the Frontier of Medical Rescue

博士论文研究：护理综合症：医疗救援前沿的生存新科学

• 批准号: 2341900
• 负责人: Adriana Petryna
• 金额: $ 1.58万
• 依托单位: University of Pennsylvania
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2024
• 资助国家: 美国
• 起止时间: 2024-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=2341900&HistoricalAwards=false
• 关键词: Doctoral; Dissertation; Research; Syndrome; Care

This doctoral dissertation research improvement grant supports a study that focuses on critical care medicine. Increasing numbers of Americans are experiencing care within Intensive Care Units (ICUs), which are hospital areas dedicated to the sickest patients and staffed by healthcare teams with advanced training in critical care medicine. Progress in the science and practice of critical care has improved survival among ICU patients. Yet some patients experience an extended period of ill-health after their ICU stay that is caused not only by illness but also by side-effects of interventions. For example, patients can suffer lasting muscle weakness from paralytic medicines used in sedation or symptoms of post-traumatic stress. These side-effects, which span physical, cognitive, and emotional domains of health, are collectively called Post-Intensive Care Syndrome. This syndrome can prevent former ICU patients from returning to their workplaces and family lives. However, it remains unclear how and by whom the medical and social ramifications of critical care can be addressed. This project will result in patient- and family-centered proposals for action to address and mitigate Post-Intensive Care Syndrome. The overarching goal of this project is to understand how medical professionals and health systems can address the consequences of intensive medical care among ICU survivors. How do healthcare workers in ICUs expand their goals and practices from short-term rescue to address the longer-term outcomes associated with Post-Intensive Care Syndrome? What new forms of longitudinal care for patients after the ICU need to be engineered? What does this syndrome reveal about the values, priorities, and challenges that underlie American health systems? While clinicians and patients alike hope for recovery, uncertainty remains about what recovery means and how it is experienced. In tracing how ICU survivorship is transformed through care practices, healthcare policy, and patient experience, this project contributes new understandings of recovery beyond medical rescue that will help to inform healthcare improvement.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

该博士论文研究改进补助金支持一项专注于重症监护医学的研究。越来越多的美国人在重症监护病房 (ICU) 中接受护理，这些病房是专门收治病情最严重的患者的医院区域，配备了接受过重症监护医学高级培训的医疗团队。重症监护科学和实践的进步提高了 ICU 患者的生存率。然而，一些患者在入住 ICU 后会经历很长一段时间的健康状况不佳，这不仅是由疾病引起的，也是由干预措施的副作用引起的。例如，患者可能因用于镇静的麻痹药物或创伤后应激症状而出现持久的肌肉无力。这些副作用涵盖身体、认知和情感健康领域，统称为重症监护后综合症。这种综合症可以阻止前 ICU 患者重返工作场所和家庭生活。然而，目前尚不清楚如何以及由谁来解决重症监护的医疗和社会影响。该项目将提出以患者和家庭为中心的行动建议，以解决和减轻重症监护后综合症。 该项目的总体目标是了解医疗专业人员和卫生系统如何解决 ICU 幸存者中重症监护的后果。重症监护病房的医护人员如何将他们的目标和实践从短期救援扩展到解决与重症监护后综合症相关的长期结果？需要为 ICU 后的患者设计哪些新的纵向护理形式？这种综合症揭示了美国卫生系统背后的价值观、优先事项和挑战是什么？尽管临床医生和患者都希望康复，但康复的含义和体验方式仍然存在不确定性。在追踪 ICU 生存率如何通过护理实践、医疗保健政策和患者体验而改变的过程中，该项目提供了对医疗救援之外的康复的新理解，这将有助于改善医疗保健。该奖项反映了 NSF 的法定使命，并被认为值得通过以下方式获得支持：使用基金会的智力价值和更广泛的影响审查标准进行评估。