Symptom Biology After Heart Failure Hospitalization

心力衰竭住院后的症状生物学

• 批准号: 10269027
• 负责人: Jonathan Patrick Auld
• 金额: $ 15.95万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-24 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10269027
• 关键词: Address; Admission activity; Adult; Affect; Age-Years; Anxiety; Area; Behavioral; Biological; Biological Markers; Biology; Cardiovascular Diseases; Clinic Visits; Clinical Data; Clinical Management; Collection; Congestive; Congestive Heart Failure; Data; Devices; Distress; Dyspnea; Early Intervention; Emergency department visit; Emergent care; Fatigue; Fibrosis; Functional disorder; Galectin 3; Goals; Growth; Health; Heart failure; Hospitalization; Hospitals; Implant; Inflammation; Interleukin-6; Intervention; K-Series Research Career Programs; Knowledge; Lead; Linear Models; Liquid substance; Longitudinal prospective study; Measurement; Mental Depression; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentorship; Mission; Modeling; Monitor; Myocardial; National Institute of Nursing Research; Nurses; Outcome; Pain; Pathology; Patient Self-Report; Patients; Pattern; Perception; Pharmaceutical Preparations; Physiological; Physiology; Postdoctoral Fellow; Procedures; Process; Publishing; Pulmonary artery structure; Quality of life; Reporting; Research; Research Project Grants; Research Training; School Nursing; Series; Sleep; Symptoms; System; TNF gene; Telephone; Time; Training; Training Activity; United States; Universities; Washington; biobehavior; care seeking; career development; clinically relevant; community setting; cost effective; design; experience; health care service utilization; health related quality of life; hospital readmission; implantable device; improved; insight; minimally invasive; mortality; muscle stress; novel; physical symptom; pressure; prevent; pro-brain natriuretic peptide (1-76); psychologic; psychological symptom; real time monitoring; remote monitoring; sensor; statistics; symptom management; symptom science; technology development

PROJECT SUMMARY The purpose of this Mentored Patient-Oriented Research Career Development Award (K23) application is to provide additional research training for Dr. Jonathan Auld, a post-doctoral fellow at the University of Washington School of Nursing. The long-term goals of the applicant are to independently lead an interdisciplinary team in biobehavioral research and to design R-series studies that guide tailored HF symptom management interventions using biological, behavioral and clinical data. Heart failure is a growing cardiovascular disorder that is characterize by high symptom burden, poor quality of life and high healthcare utilization. In addition, patients often struggle to identify and manage symptoms. A better understanding of how symptoms change after patients are discharged and the biological underpinnings of HF symptoms will provide needed information to address symptom burden earlier and to tailor symptom management intervention to improve quality of life and healthcare utilization. This career development award will support the applicant’s training and research goals through the provision of mentorship, coursework, and other training activities directly relevant to the content areas of advanced training in collection, measurement and analysis of HF biomarkers, symptom management interventions for people with chronic HF, the use of novel remote monitoring technology, and career development. The research project proposed in this application will examine how and when HF symptoms change after hospitalization. The applicant proposes a prospective longitudinal study (n=60) of adults with advance HF (NYHA III) after discharge from a HF hospitalization. Importantly, we will use novel data from CardioMEMS devices to better understand HF symptom biology. Specifically, this study aims to: 1) characterize and compare patterns of change in physical and psychological symptoms (dyspnea, fatigue, pain, depression and anxiety) biomarkers (IL-6, TNFα, NT-proBNP, sST2 and Galectin-3) and health-related quality of life over 6 months (discharge, 1 month, 3 months, 6 months) in patients with CardioMEMS and without CardioMEMS, 2) characterize and compare healthcare utilization over 6 months (medication changes, nurse phone contacts, urgent clinic visits, emergency room visits, re-hospitalizations, and mortality) in the CardioMEMS and non-CardioMEMS groups, and 3) quantify the association between CardioMEMS pulmonary artery pressure data, HF biomarkers, physical and psychological symptoms and HRQOL over 6 months. Descriptive statistics, latent growth curve modeling, parallel process growth curve modeling, and multivariate generalized linear modeling will be used to compare and characterize HF symptom trajectories, biomarker trajectories, and predictors of healthcare utilization over 6 months after discharge. Both the short and long-term goals of this Career Development Award align with the strategic mission of The National Institute of Nursing Research to understand the biological mechanisms of HF symptoms.

项目摘要 这项受过指导的以患者为导向的研究职业发展奖（K23）申请的目的 将为大学后研究员乔纳森·奥尔德（Jonathan Auld）博士提供其他研究培训。 华盛顿护理学院。申请人的长期目标是独立领导 生物行为研究和设计R系列研究的跨学科团队，以指导量身定制的HF符号 使用生物学，行为和临床数据的管理干预措施。心力衰竭是一个增长 心血管障碍的特征是症状高，生活质量差和医疗保健高 利用率。此外，患者经常难以识别和管理符号。更好地理解如何 患者出院后症状改变，HF症状的生物基础将提供 所需的信息以较早解决症状，并根据症状管理干预措施 改善生活质量和医疗保健利用。 该职业发展奖将通过 提供与与内容领域直接相关的心态，课程工作和其他培训活动 HF生物标志物的收集，测量和分析的高级培训，症状管理 患有慢性HF的人的干预措施，新型远程监控技术的使用和职业 发展。本应用程序中提出的研究项目将研究如何以及何时HF符号 住院后变化。申请人提出一项前瞻性纵向研究（n = 60）的成年人 从HF住院出院后，预先HF（NYHA III）。重要的是，我们将使用来自 心脏组件设备更好地了解HF症状生物学。具体而言，本研究的目的是：1） 表征和比较身体和心理症状变化的模式（呼吸困难，疲劳，疼痛， 抑郁和动画）生物标志物（IL-6，TNFα，NT-ProBNP，SST2和Galectin-3）和与健康相关的质量 患有心脏组患者的6个月以上的生命超过6个月（出院，1个月，3个月，6个月） Cardiomems，2）在6个月内表征和比较医疗保健利用（药物变化，护士 电话联系，紧急诊所就诊，急诊室就诊，重新住院和死亡率） 心脏组和非心脏组组，3）量化心脏瘤之间的关联 动脉压力数据，HF生物标志物，身体和心理症状以及HRQOL 6个月。 描述性统计数据，潜在生长曲线建模，并行过程生长曲线建模和多变量 广义线性建模将用于比较和表征HF符号，生物标志物 出院后6个月内，轨迹和医疗保健利用的预测因素。短期和长期 该职业发展奖的目标与国家护理研究所的战略使命保持一致 了解HF符号的生物学机制。