Center for Improving Palliative Care for Vulnerable Adults with MCC (CIPC)

改善 MCC 弱势成人姑息治疗中心 (CIPC)

基本信息

批准号：
9605905
负责人：
Jingjing Shang
金额：
$ 41.8万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-08 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9605905
关键词：
Acculturation Acute Address Adult Age Area Behavioral Model Biometry Caring Characteristics Chronic Common Data Element Communication Compassion Consultations Coupled Ecology Effectiveness End stage renal failure Ensure Environment Ethnic Origin Face Foundations Funding Future Geographic Locations Health Health Services Health behavior Hospitalization Interdisciplinary Study Knowledge Life Location Logic Medical Methods Modeling National Institute of Nursing Research New York Nurses Nursing Homes Nursing Services Outcome Output Palliative Care Patients Pattern Pilot Projects Population Principal Investigator Procedures Process Quality of life Race Research Research Infrastructure Research Methodology Research Personnel Resource Sharing Risk School Nursing Science Scientist Self Management Services Sex Orientation Socioeconomic Status Training Universities Visiting Nurse Vulnerable Populations base biobehavior care coordination formative assessment health care service utilization health care settings high risk hospice environment improved innovation meetings multilevel analysis multiple chronic conditions patient population preference programs satisfaction skills symptom management urban dwelling

项目摘要

Multiple chronic conditions (MCC), defined as two or more co-occurring chronic conditions, occur frequently in vulnerable adult patients such as those living in nursing homes or with end-stage renal disease. Vulnerable adult populations with MCC have worse health outcomes and higher utilization of all types of health services compared to those who do not have chronic conditions, and they are at higher risk of receiving inappropriate and/or burdensome services (e.g., procedures, treatments, and hospitalizations) that are inconsistent with their preferences. Medical complexity alone does not explain these differences; the issues vary on many characteristics including race/ethnicity, acculturation, and living location. Furthermore, while most palliative care is currently provided in acute care, it is recommended that interdisciplinary palliative care begin early for any serious illness and be delivered across the continuum of health care settings. There are knowledge gaps in key palliative care areas including how best to support symptom management, communication, and care coordination; these knowledge gaps must be addressed to provide effective innovative interdisciplinary care models in multiple health care settings for vulnerable adult patients with MCC to ensure they receive appropriate care that is consistent with their preference . To address these gaps, the aims of the exploratory P20 Center for Improving Palliative Care for Vulnerable Adults with MCC (CIPC) are to: 1) Develop a sustainable infrastructure that supports interdisciplinary researchers to develop into transdisciplinary teams that conduct biobehavioral, palliative care research across health care settings for vulnerable adults with MCC; 2) Develop new programs of biobehavioral, palliative care research for vulnerable adults with MCC led by nurse scientists; 3) Enhance the knowledge and skills of participating investigators on transdisciplinary, biobehavioral, palliative care research methods across health care settings for vulnerable adults with MCC and disseminate new knowledge to relevant stakeholders; and 4) Evaluate the Center's inputs, outputs, and outcomes on an ongoing and annual basis and refine processes as needed. The CIPC is uniquely poised to develop research capacity in this area. The partnership between Columbia University School of Nursing and the Visiting Nurse Service of New York increases access of pilot project investigators to vulnerable urban dwelling adults with MCC. The Enrichment Plan activities, which are informed by leading interdisciplinary palliative care clinicians, along with support from the Pilot Administrative Core with vast scientific expertise (e.g., mixed methods biobehavioral research in adults with MCC and biostatistics) and expert consultation with the Palliative Care Research Cooperative, provide an excellent foundation in best practices for biobehavioral, palliative care research. This foundation coupled with the robust research environment and strong Administrative Core increases the likelihood of the CIPC meeting its important aims which are consistent with NINR's strategic theme “End-of Life and Palliative Care: The Science of Compassion”.

多种慢性病（MCC）定义为两个或多个共同发生的慢性疾病，经常发生在弱势的成年患者，例如居住在护士家中或末期肾脏疾病的患者。具有MCC的成年人群的健康状况较差，并且对所有类型的健康服务的利用都更高与那些没有慢性疾病的人相比，他们有不适当的风险和/或朴实的服务（例如程序，治疗和住院），与他们的服务不一致偏好。仅医疗复杂性并不能解释这些差异。这些问题在许多方面有所不同包括种族/种族，适应和生活地点在内的特征。此外，虽然大多数姑息目前在急性护理中提供护理，建议跨学科的姑息治疗早期开始任何严重的疾病，并在整个医疗保健环境中进行。有知识差距在关键的姑息治疗领域，包括如何最好地支持SYM管理层，沟通和护理协调;这些知识差距必须解决以提供有效的创新跨学科护理在多个医疗保健环境中，易受伤害的MCC成年患者，以确保他们接受适当的护理与他们的喜好一致。为了解决这些差距，探索的目的 P20针对MCC（CIPC）的脆弱成年人改善姑息治疗中心（CIPC）为：1）支持跨学科研究人员发展成跨学科团队的可持续基础设施为MCC的脆弱成年人进行跨卫生保健环境的生物行为，姑息治疗研究； 2）制定针对由MCC领导的脆弱成年人的生物行为，姑息治疗研究的新计划护士科学家； 3）增强参与跨学科研究人员的知识和技能， MCC和MCC和向相关利益相关者传播新知识； 4）评估中心的输入，输出和根据需要进行的持续和每年的进步。 CIPC被唯一中毒在该领域发展研究能力。哥伦比亚大学护理学院与纽约来访的护士服务增加了试点项目调查人员对弱势城市的访问带有MCC的成年人。丰富计划活动，通过领先的跨学科告知姑息治疗临床医生，以及飞行员行政核心的支持，并拥有丰富的科学专业知识（例如，MCC和生物统计学成人的混合方法生物行为研究）以及与专家咨询姑息治疗研究合作社为生物行为的最佳实践提供了良好的基础，姑息治疗研究。该基础与强大的研究环境和强大的结合行政核心增加了CIPC达到其重要目标的可能性 Ninr的战略主题“生命终结与姑息治疗：同情科学”。