Mid-Career Mentoring Award in Palliative Care, Aging, and Cognitive Impairment

姑息治疗、老龄化和认知障碍领域的职业生涯中期指导奖

基本信息

批准号：
10369952
负责人：
David B. Bekelman
金额：
$ 18.83万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-15 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10369952
关键词：
Adult Advance Care Planning Aging Alzheimer&apos s disease related dementia Award Cardiology Cardiopulmonary Caregiver support Caregiver well-being Caregivers Chronic Obstructive Pulmonary Disease Clinical Cognition Cognitive Collaborations Colorado Consolidated Framework for Implementation Research Data Dementia Development Disadvantaged Discipline of Nursing Disease Elderly Environment Family Caregiver Funding Geriatrics Goals Health Heart failure Hispanic Impaired cognition Individual Internist Intervention Knowledge Medicaid Medical Memory Mentors Mentorship Methods Multi-Institutional Clinical Trial Outcome Palliative Care Participant Patient Care Patients Personal Satisfaction Persons Positioning Attribute Primary Health Care Psychiatrist Psychology Public Health Pulmonology Quality of life Research Research Activity Research Personnel Resources Scientist Screening procedure Social Work Specialist Telephone Interviews Testing Thinking Time Training United States National Institutes of Health Universities Visit Work age related care outcomes career career development cognitive function cognitive interview comorbidity design disability disadvantaged population diverse data effectiveness study end of life evidence base experience implementation science improved interest intervention effect mild cognitive impairment multi-site trial next generation patient oriented patient oriented research patient population prevent primary care setting programs rural setting skills success symptom treatment

项目摘要

PROJECT SUMMARY Palliative care focuses on improving quality of life for people with serious illness and their family caregivers at any stage of illness and aligning medical treatments with a persons' values and goals. Older adults with serious illnesses such as heart failure (HF) or chronic obstructive pulmonary disease (COPD) have numerous palliative care needs. However, palliative care is often provided late in illness by palliative care specialists, near the end of life. In addition, palliative care is a limited resource that is not available to many of the patients with HF or COPD and their family caregivers, especially in urban poor and rural settings. Furthermore, many older adults with HF or COPD have comorbid cognitive impairment and dementia which are associated with worse outcomes. In prior work, I tested the effect of early palliative care interventions for adults with HF or COPD. In this application, I propose new research to determine how to adapt and implement early palliative care into the primary care setting for patients with HF or COPD who have cognitive impairment or Alzheimer's disease and related dementias. The overall goals of this proposal are to (1) train mentees (through increased mentoring time) to increase the cadre of successful patient-oriented researchers who will improve care and outcomes for older adults with serious illness and cognitive impairment, and (2) expand my research skills and experience in cognitive impairment and implementation science research for seriously ill older adults in primary care. I will accomplish these goals through additional training, research experience, and mentorship from experts in cognitive impairment, implementation science, and mentoring. During the K24, I will work closely with mentees to develop individual career plans and conduct research to further their development as independent investigators in palliative care, aging, and cognitive impairment. The research proposed in this application will: (1) determine how cognitive impairment influences participation in early palliative care and palliative care outcomes; we will analyze cognitive function and quality of life data from two of my multisite clinical trials (one completed, one active) of older adults with HF or COPD, and (2) engage primary care stakeholders (clinicians, leaders, staff, patients, and caregivers) to identify which palliative care interventions to implement in primary care and how to implement them. The proposed research, conducted with implementation science collaborators and mentees, will provide new knowledge on how to adapt and implement early palliative care into primary care for older adults with HF or COPD and cognitive impairment, including Alzheimer's disease and related dementias. I am thrilled to train the next generation of patient-oriented researchers in palliative care, aging, and cognitive impairment. With my record of research and mentoring success and the resources from the K24 and the University of Colorado, I can provide an outstanding training environment.

项目概要姑息治疗的重点是改善严重疾病患者及其家庭护理人员的生活质量疾病的任何阶段，并使医疗治疗与个人的价值观和目标保持一致。老年人有严重疾病如心力衰竭（HF）或慢性阻塞性肺病（COPD）有许多姑息治疗的需求。然而，姑息治疗通常是在疾病晚期由姑息治疗专家在附近提供的。生命的终结。此外，姑息治疗是一种有限的资源，许多患者无法获得心力衰竭或慢性阻塞性肺病及其家庭照顾者，特别是在城市贫困人口和农村地区。此外，许多年纪较大的患有心力衰竭或慢性阻塞性肺病的成年人患有认知障碍和痴呆症，这与更严重的情况相关结果。在之前的工作中，我测试了早期姑息治疗干预措施对患有心力衰竭或慢性阻塞性肺病的成人的效果。在在这个应用程序中，我提出了新的研究，以确定如何将早期姑息治疗适应和实施到患有认知障碍或阿尔茨海默病的心力衰竭或慢性阻塞性肺病患者的初级保健机构，以及相关痴呆症。该提案的总体目标是 (1) 培训受训者（通过增加指导）时间）以增加以患者为中心的成功研究人员的队伍，他们将改善患者的护理和结果患有严重疾病和认知障碍的老年人，以及（2）扩展我的研究技能和经验初级保健中重病老年人的认知障碍和实施科学研究。我会通过额外的培训、研究经验和专家的指导来实现这些目标认知障碍、实施科学和指导。在K24期间，我将与学员密切合作制定个人职业计划并进行研究以进一步发展他们的独立能力姑息治疗、衰老和认知障碍方面的研究人员。本申请中提出的研究将： (1) 确定认知障碍如何影响早期姑息治疗和姑息治疗的参与结果；我们将分析我的两项多中心临床试验的认知功能和生活质量数据（一项 (2) 参与初级保健利益相关者（临床医生、领导者、工作人员、患者和护理人员）以确定在初级阶段实施哪些姑息治疗干预措施护理以及如何实施它们。拟议的研究是通过实施科学进行的合作者和学员将提供有关如何适应和实施早期姑息治疗的新知识为患有心力衰竭或慢性阻塞性肺病和认知障碍（包括阿尔茨海默病）的老年人提供初级保健服务以及相关的痴呆症。我很高兴能够培训下一代以患者为中心的姑息治疗研究人员护理、衰老和认知障碍。凭借我的研究和指导成功记录以及资源来自K24和科罗拉多大学的我可以提供优秀的培训环境。