Sleep and Cognition after Left Ventricular Assist Device Implantation

左心室辅助装置植入后的睡眠和认知

• 批准号: 10579180
• 负责人: Tao ZHENG
• 金额: $ 4.77万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10579180
• 关键词: Address; Anxiety; Arousal; Attention; Auditory; Award; Cardiac Output; Caring; Clinical; Cognition; Data; Data Collection; Dedications; Destinations; Devices; Drowsiness; Elderly; Event; Fellowship; Foundations; Fright; Future; Goals; Health; Heart Transplantation; Heart failure; Home; Impaired cognition; Impaired health; Impairment; Implant; Implantation procedure; Individual; Individual National Research Service Award; Influentials; Intervention; Investigation; Israel; Knowledge; Language; Life; Life Style Modification; Link; Literature; Measures; Mechanics; Medical; Memory Loss; Mental Depression; Mental Health; Methods; Neurobehavioral Manifestations; Nursing Research; Operative Surgical Procedures; Organ; Outcome; Patients; Persons; Physiological; Population; Postoperative Pain; Postoperative Period; Productivity; Pump; Quality of life; Recovery; Refractory; Research; Research Personnel; Research Training; Risk; Schedule; School Nursing; Science; Sleep; Sleep Disorders; Sleep disturbances; Space Perception; Specific qualifier value; Speed; Symptoms; Technology; Therapeutic; Time; Training; Transplantation; Treatment Failure; Universities; Visuospatial; Washington; actigraphy; anxiety symptoms; biobehavior; biomaterial compatibility; cognitive function; comorbidity; depressive symptoms; doctoral student; executive function; experience; health related quality of life; high risk; implantable device; implantation; improved; indexing; innovation; left ventricular assist device; mechanical circulatory support; mortality; novel; optimal treatments; physical symptom; poor sleep; portability; pre-doctoral; processing speed; programs; prospective; psychologic; psychological distress; psychological symptom; reduce symptoms; respiratory; sleep onset; sleep quality; symptom management; symptomatic improvement; symptomatology; therapy development; verbal; visual memory

PROJECT SUMMARY The purpose of this Ruth L. Kirschstein National Research Service Award (NRSA) Individual Pre-Doctoral Fellowship in Nursing Research (F31) application is to provide research training for Mr. Zheng, a second-year doctoral student at the University of Washington School of Nursing. The long-term goal of this training is for this applicant to develop into an independent influential researcher in a research-intensive academic setting with an innovative and productive interdisciplinary program. This research will be dedicated to integrating physiologic measures into bio-behavioral interventions to reduce and ameliorate symptom burden in individuals with advanced heart failure (AHF) and mechanical circulatory support (MCS) devices. Individuals with AHF experience severe refractory symptom burden despite maximum medical therapy. Cardiac transplant is the optimal treatment option for AHF. However, organ shortage and ineligibility for transplant make MCS devices, such as Left Ventricular Assist Devices (LVADs), the only treatment option for individuals with advanced age and comorbid conditions requiring permanent support, known as destination therapy (DT). The number of patients attaining longer-term survival with DT-LVAD is rapidly growing with increased durability of mechanical support, and expanded indications for DT-LVAD to include patients in earlier stages of heart failure. While studies on sleep and sleep disorders among individuals with heart failure are extensive, investigating sleep as an important clinical outcome for DT-LVAD recipients has not kept pace with the rapidly expanding therapeutic indications and evolving technology advancements in MCS for AHF care. Better understanding of LVAD effects on physical and psychological symptoms will be essential to effectively care for, and support LVAD patients post-implant. The purpose of this prospective concurrent mixed-methods study is to describe changes in objective and subjective sleep quality at 3 months in persons with AHF following DT-LVAD, and to determine associations between change in sleep quality as they relate to changes in cognitive function, psychological symptoms and health-related quality of life. Moreover, this award will prepare a pre-doctoral trainee through advanced coursework and direct research experience, the use of mixed methods, focused analysis of symptom changes observed post-LVAD implant, and discovery of highly relevant links among multiple sleep and AHF-related symptoms. Findings generated from this investigation will provide foundational knowledge for building a new program of research in symptom and symptom management science in AHF.

项目概要 Ruth L. Kirschstein 国家研究服务奖 (NRSA) 个人博士前奖学金的目的 护理研究奖学金（F31）申请是为二年级郑先生提供研究培训 华盛顿大学护理学院博士生。本次培训的长远目标是 该申请人在研究密集型学术环境中发展成为一名独立且有影响力的研究员 具有创新和富有成效的跨学科项目。这项研究将致力于整合 将生理措施纳入生物行为干预措施，以减少和改善个体的症状负担 具有高级心力衰竭（AHF）和机械循环支持（MCS）设备。患有 AHF 的人 尽管进行了最大程度的药物治疗，仍经历严重的难治性症状负担。心脏移植是 AHF 的最佳治疗选择。然而，器官短缺和不适合移植使得MCS设备， 例如左心室辅助装置 (LVAD)，这是高龄人士的唯一治疗选择 以及需要永久支持的共病，称为目的地治疗 (DT)。数量 随着机械耐久性的提高，通过 DT-LVAD 获得长期生存的患者数量正在迅速增加 支持，并将 DT-LVAD 的适应症扩大到包括处于心力衰竭早期阶段的患者。尽管 关于心力衰竭患者的睡眠和睡眠障碍的研究非常广泛，调查睡眠作为 DT-LVAD 接受者的一项重要临床结果未能跟上快速扩展的治疗方法 AHF 护理 MCS 的适应症和不断发展的技术进步。更好地了解 LVAD 效应 对身体和心理症状的了解对于有效护理和支持 LVAD 患者至关重要 植入后。这项前瞻性并发混合方法研究的目的是描述 DT-LVAD 后 3 个月时 AHF 患者的客观和主观睡眠质量，并确定 睡眠质量变化与认知功能、心理变化之间的关联 症状和健康相关的生活质量。此外，该奖项将通过以下方式培养一名博士前实习生： 先进的课程和直接的研究经验，使用混合方法，集中分析 LVAD 植入后观察到的症状变化，并发现多次睡眠之间高度相关的联系 和 AHF 相关症状。这项调查的结果将为以下方面提供基础知识： 建立 AHF 症状和症状管理科学的新研究计划。