Improving Older Adults' Decision Making For Obstructive Sleep Apnea Treatment

改善老年人阻塞性睡眠呼吸暂停治疗的决策

• 批准号: 8591037
• 负责人: Constance Fung
• 金额: $ 15.9万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8591037
• 关键词: Adherence; Adult; Adverse effects; Affect; American; Arthritis; Attention; Attitude; Award; Behavior; Benefits and Risks; Board Certification; Breathing; Caring; Characteristics; Clinical; Clinical Sciences; Clinical Trials; Commit; Control Groups; Data; Data Reporting; Decision Aid; Decision Making; Education; Effectiveness; Elderly; Environment; Equipment; Face; Fellowship; Focus Groups; Foundations; Funding; Future; Geriatrics; Goals; Health; Health Professional; Health Services Research; Health system; Healthcare; Healthcare Systems; Impaired cognition; Individual; Institutes; Interview; Knowledge; Leadership; Los Angeles; Measures; Medical; Medicine; Mentors; Methods; Modality; Newly Diagnosed; Obstructive Sleep Apnea; Outcome; Outcomes Research; Participant; Patient Care; Patient Preferences; Patient-Centered Care; Patient-Focused Outcomes; Patients; Phase; Physicians; Planning Theory; Population; Preparation; Process; Psychosocial Factor; Qualitative Methods; Questionnaires; Randomized Controlled Trials; Reporting; Research; Research Institute; Research Personnel; Research Training; Resources; Risk; Sampling; Seeds; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Stroke; Structure; Surveys; Testing; Training; Translational Research; Validity and Reliability; Vehicle crash; base; career; career development; cost; design; experience; health related quality of life; improved; innovation; interest; medical schools; meetings; novel; patient oriented; preference; pressure; prototype; psychosocial; risk perception; secondary outcome; shared decision making; skills; tool; trial comparing; usability

DESCRIPTION (provided by applicant): Constance H. Fung, MD, MSHS is committed to becoming an independently-funded investigator who develops and implements patient-centered strategies for helping older adults make informed health care decisions that incorporate their preferences and needs. She has a particular interest in applying these strategies to care of older adults who have obstructive sleep apnea (OSA). Her unique background makes her an ideal candidate for this field of research. She has fellowship training and board certification in both Geriatrics and Sleep Medicine, fellowship training in Health Services Research, and leadership and research experience in improving patient care. Currently, Dr. Fung is supported by seed funding from the American Sleep Medicine Foundation and the UCLA/Hartford Center of Excellence. She is completing a qualitative study on barriers to OSA equipment use among older adults. Career development and training plan: This plan features an outstanding research and education environment at the David Geffen School of Medicine at UCLA, as well as interdisciplinary mentoring by researchers experienced in conducting sleep-related clinical trials in older adults, developing tools to improve shared decision making, and improving patient-centered care. Additional key resources include the UCLA/Hartford Center of Excellence, UCLA Clinical and Translational Science Institute, and the VA Greater Los Angeles Healthcare System Geriatrics, Research, Education and Clinical Center. This plan also features carefully selected formal coursework as well as hands-on training. Research plan: The overall goal of the proposed research is to develop and test a strategy for incorporating individual older adults' preferences and needs into treatment decisions about OSA. This project will develop and test a decision aid for older adults who are newly diagnosed with OSA and face various treatment options. In phase 1, she will explore the factors that impact OSA treatment decisions among older adults, using qualitative methods and a patient survey. In phase 2, she will use these findings to develop a decision aid tailored to older adults with OSA. In phase 3, she will collect feasibility data for a future randomized controlled trial that will compare the decision aid to an attention control. Information on process variables (e.g., recruitment rates) and effect size for primary (acceptance/adherence, decision-related outcomes) and secondary outcomes (sleep, other health-related, and health system outcomes) will inform the design of a future large-scale R01- or PCORI-funded trial. Skills developed from executing this training and research plan will enable Dr. Fung to become an independent researcher and leader in strategies for helping older adults incorporate their preferences and needs into medical decisions.

描述（由申请人提供）：MSHS Constance H. Fung，医学博士，致力于成为一名独立资助的调查员，他们制定并实施了以患者为中心的策略来帮助老年人做出融合其偏好和需求的知情医疗保健决策。她特别有兴趣应用这些策略来照顾患有阻塞性睡眠呼吸暂停（OSA）的老年人。她独特的背景使她成为这一研究领域的理想候选人。她在老年医学和睡眠医学，卫生服务研究方面的研究金培训以及改善患者护理方面的领导力和研究经验方面都接受了研究金培训和董事会认证。目前，Fung博士得到了美国睡眠医学基金会和UCLA/Hartford卓越中心的种子资金的支持。她正在完成一项关于老年人OSA设备使用障碍的定性研究。职业发展和培训计划：该计划在加州大学洛杉矶分校的David Geffen医学院的杰出研究和教育环境中以及经验丰富的老年人进行与睡眠有关的临床试验的研究人员的跨学科指导，开发了改善共同决策的工具，并改善了以患者为中心的护理。其他关键资源包括加州大学洛杉矶分校/哈特福德卓越中心，加州大学洛杉矶分校临床和转化科学学院以及弗吉尼亚州大洛杉矶医疗保健系统老年医学，研究，教育和临床中心。该计划还具有精心选择的正式课程以及动手培训。研究计划：拟议的研究的总体目标是制定和测试将单个老年人的偏好和需求纳入有关OSA的治疗决策的策略。该项目将为新诊断为OSA并面临各种治疗选择的老年人开发和测试决策援助。在第1阶段，她将使用定性方法和患者调查探讨影响老年人OSA治疗决策的因素。在第2阶段，她将使用这些发现来开发针对OSA老年人量身定制的决策援助。在第3阶段，她将收集可行性数据，以进行将来的随机对照试验，该试验将将决策援助与注意力控制进行比较。有关过程变量（例如招聘率）和主要效果大小的信息（接受/依从性，与决策相关的结果）和次要结果（睡眠，其他与健康相关的和卫生系统）的信息将为未来的大规模R01或PCORI资助的试验提供信息。通过执行这项培训和研究计划而发展的技能将使Fung博士成为帮助老年人将他们的偏好和需求纳入医疗决策的策略的独立研究者和领导者。