Developing Capacity to Improve Care Transitions for Injury Patients in Tanzania

发展能力以改善坦桑尼亚受伤患者的护理过渡

基本信息

批准号：
10018233
负责人：
Janet Alexandria Prvu Bettger
金额：
$ 12.51万
依托单位：
DUKE UNIVERSITY
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：
2018-02-01 至 2021-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10018233
关键词：
Acute Address Adult Age-Years Alcohol or Other Drugs use Area Caring Cause of Death Cessation of life Chronic Disease Clinical Clinical Trials Communities Comorbidity Complex Comprehensive Health Care Country Data Family Family member Future General Population Goals HIV HIV diagnosis Health Health system Hospitalization Hospitals Human immunodeficiency virus test Income Individual Injury International Intervention Interview Length of Stay Low income Medical Medical center Mental Health Modeling Morbidity - disease rate Newly Diagnosed Outcome Pain Pathway interactions Patient-Focused Outcomes Patients Persistent pain Physically Handicapped Population Quality of life Registries Research Research Personnel Resources Risk Risk Factors Services Substance abuse problem Tanzania Testing Transitional Care Planning Trauma Trauma patient base data registry disability disability-adjusted life years evidence base follow-up global health health management high risk implementation science improved injured international center low and middle-income countries low income country mortality multidisciplinary posthospitalization care social standard of care years of life lost

项目摘要

Abstract: Injuries are a global health crisis annually causing 6 million deaths and over 650 million people worldwide living with disabilities. Injuries have a particular impact on people between 5 and 44 years of age and are the leading cause of disability adjusted life years lost in low and middle income settings. Strategies to assist newly injury patients in their transition from the acute setting to the community reduce mortality and morbidity in high income settings. Comprehensive and evidence based transition of care strategies are not currently used in most low income settings due to a myriad of limitations. Over 2000 patients annually are seen at Kilimanjaro Christian Medical Center (KCMC) for acute injuries of which 59% are admitted for an average length of stay of 10 days. Upon discharge from an acute injury hospitalization, adult injury patients have a complex array of complications across the ‘five domains’ of healthcare management which include function, mental health, substance abuse, pain, and comorbidities (which includes HIV). In high income countries, up to 79% of injury patients suffer complications in one of these domains post hospitalization. While data is lacking, preliminary data in the region suggests that HIV is more common in the injury population than the general public and could worsen outcomes. Managing the health and social needs of an adult injury patient post hospitalization requires a multidisciplinary team to address each of these domains. The goal of this important project is to build capacity in order to improve the health and quality of life for injury patients, particularly focusing on our five health domains, by (1) understanding and addressing the care transition needs (including any HIV related needs), and (2) creating a resource-appropriate comprehensive care transitions strategy. Ultimately, we will build the research capacity to qualitatively develop and feasibly test this intervention. By the conclusion of this project, we will have created a team of local and international health system clinical researchers, a high quality injury registry, a descriptive understanding of the rates of known and newly diagnosed HIV as well as the complications HIV patients suffer during acute injuries, and an piloted evidence-based and resource-appropriate care transition strategy feasible for implementation in a fully powered clinical trial. There is tremendous potential for this research to strengthen care pathways at KCMC for injury patients with and without HIV, build capacity for pragmatic stakeholder-engaged clinical trials, and improve patient and family outcomes.

抽象的：伤害是一场全球性的健康危机，每年造成 600 万人死亡，全世界有超过 6.5 亿人死亡伤害对 5 岁至 44 岁之间的人群影响尤为严重，并且是最主要的影响因素。残疾原因调整了低收入和中等收入环境中损失的生命年帮助新受伤者的策略。患者从急性环境过渡到社区可降低高死亡率和发病率收入环境中目前尚未使用全面且基于证据的护理过渡策略。由于无数的限制，大多数低收入环境。乞力马扎罗基督教医疗中心 (KCMC) 每年接待超过 2000 名患者因急性损伤而就诊。其中 59% 因急性损伤出院后平均住院 10 天。住院期间，成人损伤患者会出现一系列复杂的并发症，涉及“五个领域” 医疗保健管理，包括功能、心理健康、药物滥用、疼痛和合并症（其中包括艾滋病毒）。在高收入国家，高达 79% 的损伤患者患有其中一种并发症。虽然缺乏数据，但该地区的初步数据表明，艾滋病毒感染率更高。在受伤人群中比普通公众更常见，并且可能会恶化健康和管理结果。成年受伤患者住院后的社会需求需要多学科团队来满足每个这些域。这个重要项目的目标是建设能力，以改善受伤后的健康和生活质量患者，特别关注我们的五个健康领域，通过 (1) 理解和解决护理问题过渡需求（包括任何与艾滋病毒相关的需求），以及 (2) 建立资源适当的综合性最终，我们将建立高质量发展和可行的研究能力。测试此干预措施到该项目结束时，我们将创建一个由本地和国际人员组成的团队。卫生系统临床研究人员、高质量的伤害登记、对受伤率的描述性了解已知和新诊断的艾滋病毒以及艾滋病毒患者在急性损伤期间遭受的并发症，以及试点的基于证据和资源适当的护理过渡战略是可行的，可以在全面这项研究对于加强 KCMC 的护理途径具有巨大的潜力。感染和未感染艾滋病毒的伤害患者，建立务实的利益相关者参与临床试验的能力，以及改善患者和家庭的治疗结果。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Barriers to accessing follow up care in post-hospitalized trauma patients in Moshi, Tanzania: A mixed methods study.

DOI：
10.1371/journal.pgph.0000277
发表时间：
2022
期刊：
PLOS global public health
影响因子：
0
作者：
Joiner, Anjni Patel;Tupetz, Anna;Peter, Timothy Antipas;Raymond, Julius;Macha, Victoria Gerald;Vissoci, Joao Ricardo Nickenig;Staton, Catherine
通讯作者：
Staton, Catherine

A systematic review and cross-sectional survey of rehabilitation resources for injury patients in the Kilimanjaro Region of Tanzania.

对坦桑尼亚乞力马扎罗地区受伤患者康复资源的系统回顾和横断面调查。

DOI：
10.1080/09638288.2023.2179674
发表时间：
2024
期刊：
Disability and rehabilitation
影响因子：
2.2
作者：
Zimmerman,Armand;Minnig,MaryCatherine;Meela,Joseph;Tupetz,Anna;Bettger,JanetPrvu;Vissoci,JoaoRicardoNickenig;Staton,Catherine
通讯作者：
Staton,Catherine

"I Don't Do Anything; I'm Just Being Taken Care Of": Experiences of Patients and Their Caregivers Transitioning Back into the Community Following Traumatic Injury in Northern Tanzania.

DOI：
10.3390/traumacare2020028
发表时间：
2022-06
期刊：
Trauma care (Basel, Switzerland)
影响因子：
0
作者：
Tupetz A;Barcenas LK;Isaacson JE;Nickenig Vissoci JR;Gerald V;Kingazi JR;Mushi I;Peter TA;Staton CA;Mmbaga BT;Bettger JP
通讯作者：
Bettger JP

Injury characteristics and their association with clinical complications among emergency care patients in Tanzania.