Improving Health Outcomes Through Enhanced Patient-Provider Relationships

通过加强患者与提供者的关系改善健康结果

基本信息

批准号：
9318450
负责人：
Michelle L Dossett
金额：
$ 16.48万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-01 至 2021-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9318450
关键词：
Acids Affect Area Arts Assessment tool Autonomic nervous system Behavior Behavioral Behavioral Mechanisms Biological Markers Biological Models Biometry Caring Characteristics Chin Chronic Clinical Management Clinical Trials Complementary Medicine Complex Cues Data Development Doctor of Philosophy Empathy Environment Facial Expression Feeling Foundations Frequencies Galvanic Skin Response Gastroesophageal reflux disease Goals Head Health Health Personnel Hearing Heartburn Human Individual Integrative Medicine Interview K-Series Research Career Programs Measurable Measurement Measures Mediating Medical Medicine Mentors Methods Mind-Body Intervention Observational Study Omeprazole Outcome Patient-Focused Outcomes Patients Perception Pharmaceutical Preparations Physicians Physiological Pilot Projects Population Process Provider Qualitative Research Quality of Care Randomized Controlled Trials Recording of previous events Reflux Reporting Research Research Personnel Resources Science Severities Stress Symptoms Testing Therapeutic Time Training Training Support Validation Visit Work behavioral response career career development clinically relevant design experience healing heart rate variability improved insight interest laboratory experience multidisciplinary neural correlate rapid growth research study response symptomatic improvement

项目摘要

Project Summary / Abstract This K23 career development award will support the training and career development of the Candidate to develop expertise in measuring and evaluating patient-provider relationships – the core of the healing arts – and their effects on health outcomes. While this relationship influences symptoms in many different conditions, we know little about the mechanisms underlying its effect or how to augment it. The rapid growth of complementary and integrative medicine (IM) may, in part, be due to a qualitative difference in patient-provider relationships compared to conventional medicine. Training in three critical areas will facilitate the Candidate’s transition to independence: 1) measurement and analysis of physiologic biomarkers of autonomic nervous system activity including galvanic skin response (GSR) and heart rate variability (HRV); 2) design, execution, and analysis of qualitative research with a focus on analysis of videos of patient-provider interactions; and 3) design and management of clinical trials and relevant biostatistical analyses. These training goals will be supported by 1) a stellar team of mentors and consultants – Maurizio Fava, MD (primary mentor), John Denninger, MD, PhD (co-mentor), and consultants Chin Hur, MD, MPH, Prof.Ted Kaptchuk, Eric Macklin, PhD, Vitaly Napadow, PhD, Elyse Park, PhD, MPH, and Cheng-Kang Peng, PhD; 2) a resource-rich institutional environment; 3) targeted advanced coursework, mentored laboratory experiences, and research seminars; and 4) the proposed research studies. Using gastroesophageal reflux disease (GERD) as a model system, the proposed studies will seek to 1) identify physiologic responses associated with GERD symptom improvement in enhanced patient-provider interactions, 2) use qualitative approaches to determine the visit characteristics associated with the identified physiologic responses, and 3) determine whether enhanced patient-provider interactions (similar to an IM provider visit) vs. empathic, conventional medical visits can augment the effect of omeprazole on GERD symptom improvement in a pilot randomized controlled trial. Results of the proposed studies will provide insights into the mechanisms underlying effective patient-provider relations, preliminary data for an R01 application, and will effectively lay the foundation for a career focused on studying patient- provider relations and their effects on health outcomes. While initial studies will focus on GERD, it is anticipated that the mechanisms identified will be broadly applicable to range of different health conditions and have implications for improving quality of care in the conventional medical setting and training of healthcare providers.

项目概要/摘要该 K23 职业发展奖将支持候选人的培训和职业发展培养衡量和评估医患关系的专业知识——治疗艺术的核心—— 虽然这种关系会影响许多不同情况下的症状，我们对其影响的机制或如何增强其快速增长知之甚少。补充和综合医学（IM）可能部分是由于患者与提供者之间的质的差异与传统医学相比，在三个关键领域的培训将促进候选人的关系。向独立过渡：1）自主神经生理生物标志物的测量和分析系统活动，包括皮肤电反应 (GSR) 和心率变异性 (HRV)；2) 设计、执行、定性研究分析，重点分析患者与提供者互动的视频；3) 这些培训目标将是临床试验的设计和管理以及相关的生物统计分析。由 1) 一流的导师和顾问团队支持 – Maurizio Fava, MD（主要导师）、John Denninger，医学博士、博士（共同导师）和顾问 Chin Hur，医学博士、公共卫生硕士、Ted Kaptchuk 教授、Eric Macklin 博士、 Vitaly Napadow 博士、Elyse Park 博士、公共卫生硕士和 Cheng-Kang Peng 博士 2) 资源丰富的机构；环境；3）有针对性的高级课程、指导实验室经验和研究研讨会； 4）拟议的研究使用胃食管反流病（GERD）作为模型系统。拟议的研究将寻求 1) 确定与 GERD 症状改善相关的生理反应在增强患者与提供者的互动中，2) 使用定性方法来确定就诊特征与已识别的生理反应相关，3) 确定是否增强患者提供者互动（类似于 IM 提供者就诊）与同理心，传统的医疗就诊可以增强以下效果：奥美拉唑对 GERD 症状改善的初步随机对照试验的结果。研究将深入了解有效的医患关系背后的机制，初步 R01 应用程序的数据，并将有效地为专注于研究患者的职业奠定基础虽然最初的研究将集中于 GERD，但事实并非如此。预计所确定的机制将广泛适用于一系列不同的健康状况和对提高传统医疗环境中的护理质量和医疗保健培训具有影响提供商。