Physical Frailty and Symptom Monitoring and Management Behaviors in Heart Failure (PRISM-HF)

心力衰竭的身体虚弱和症状监测和管理行为 (PRISM-HF)

基本信息

批准号：
10740609
负责人：
Quin Eleanor Denfeld
金额：
$ 41.77万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-19 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10740609
关键词：
Accounting Address Adult Adverse effects Adverse event Affect Age Behavior Behavioral Biological Body Weight decreased Cardiovascular system Clinical Complement Data Decision Making Development Dyspnea Event Exertion Future Goals Health Promotion Heart failure Hospitalization Intervention Interview Knowledge Logistic Models Maintenance Methods Modeling Monitor Outcome Patient-Focused Outcomes Patients Phase Phenotype Physical activity Physical assessment Physiological Precision Health Provider Public Health Quality of life Reporting Research Risk Sampling Self Care Sex Differences Structure Sum Symptoms System Time Woman Work adverse outcome biobehavior comorbidity design exhaustion experience frailty health disparity health equity improved innovation insight lens men outcome disparities prevent sex symptom management theories

Accounting Address Adult Adverse effects Adverse event Affect Age Behavior Behavioral Biological Body Weight decreased Cardiovascular system Clinical Complement Data Decision Making Development Dyspnea Event Exertion Future Goals Health Promotion Heart failure Hospitalization Intervention Interview Knowledge Logistic Models Maintenance Methods Modeling Monitor Outcome Patient-Focused Outcomes Patients Phase Phenotype Physical activity Physical assessment Physiological Precision Health Provider Public Health Quality of life Reporting Research Risk Sampling Self Care Sex Differences Structure Sum Symptoms System Time Woman Work adverse outcome biobehavior comorbidity design exhaustion experience frailty health disparity health equity improved innovation insight lens men outcome disparities prevent sex symptom management theories

展开

项目摘要

PROJECT SUMMARY While heart failure (HF) is the fastest growing cardiovascular condition in the U.S., about half of adults with HF are also considered physically frail. In recent years, there is a better understanding of the intersection of physical frailty with HF, including the strong association between physical frailty and worse patient-reported and clinical outcomes in HF. Additionally, evidence shows that physical frailty affects women more than men in HF. However, there is a lack of understanding of how physical frailty is associated with adverse outcomes, which hinders our ability to develop and deploy effective biobehavioral interventions to mitigate these adverse outcomes. While there has been work characterizing the biological profile of physical frailty in HF, the behavioral profile has not been characterized from either a quantitative or qualitative perspective. One key behavior that adults with HF must engage in is symptom monitoring and management (SMM). Monitoring for HF symptoms and engaging in decision-making to address these symptoms (e.g. recognizing dyspnea on exertion and calling a provider) are important behaviors that reduce adverse patient-reported and clinical outcomes. Physical frailty, however, may impact SMM behaviors by blunting the monitoring of symptoms and hindering the management of symptoms, resulting in adverse outcomes. Understanding the relationship of physical frailty with SMM behaviors may characterize the behavioral profile of physically frail adults with HF, offer one possible explanation by which physical frailty affects outcomes in HF, and provide a means of developing and deploying effective biobehavioral interventions to address physical frailty in HF, our long-term goal. Therefore, the objectives of this exploratory study are to 1) characterize the relationship between physical frailty, SMM behaviors, and outcomes, and 2) identify SMM behaviors, aligned with the patient's perspective, to target with biobehavioral interventions. The proposed study utilizes a sequential mixed methods approach wherein in Phase 1, we will collect cross-sectional quantitative data from a sex-balanced sample of 120 adults with HF, and in Phase 2, we will collect qualitative data from ~32-40 adults with the following aims: 1) quantify associations among physical frailty, SMM behaviors, and outcomes in adults with HF; 2) describe the experience of SMM behaviors for physically frail and non- physically frail adults with HF; and 3) identify the SMM behavioral needs of physically frail and non-physically frail adults with HF. Accomplishing this state-of-the-art study is an important stepping stone towards the development of larger proposals. Specifically, it will allow our team to merge our understanding of physical frailty from a biological perspective with that of a behavioral perspective to develop biobehavioral interventions to mitigate the adverse patient-reported and clinical outcomes associated with physical frailty in HF.

项目摘要虽然心力衰竭（HF）是美国增长最快的心血管状况，但大约一半的HF成年人也被认为是身体虚弱的。近年来，对身体的交集有更好的了解与HF的脆弱，包括身体虚弱和患者报告和临床较差的牢固关联 HF的结果。此外，有证据表明，身体虚弱对女性的影响比HF中的男性更大。然而，缺乏了解身体脆弱与不利结果如何相关的，这阻碍了我们能够开发和部署有效的生物行为干预措施以减轻这些不良结果。尽管已经表征了HF中身体虚弱的生物学特征的工作，行为概况尚未从定量或定性的角度来表征。成人HF的一种关键行为必须参与症状监测和管理（SMM）。监测HF症状并参与解决这些症状的决策（例如认识到劳动呼吸困难并打电话给提供者）减少患者报告和临床结果的重要行为。但是，身体虚弱可能通过削弱监测症状并阻碍症状的管理来影响SMM行为，导致不良结果。了解身体虚弱与SMM行为的关系可能表征具有HF的身体脆弱成年人的行为概况，提供一种可能的解释身体虚弱会影响HF的结果，并提供一种开发和部署有效生物行为的方法解决HF的身体脆弱的干预措施，这是我们的长期目标。因此，此探索性的目标研究是1）表征身体虚弱，SMM行为和结果之间的关系，以及2）识别与患者的观点一致的SMM行为，以实现生物行为干预措施。这拟议的研究采用了一种顺序混合方法方法，其中在第1阶段，我们将收集横截面来自HF的120名成年人的性均衡样本的定量数据，在第2阶段，我们将收集定性来自〜32-40名成年人的数据以下目的：1）量化物理脆弱，SMM行为之间的关联， HF成年人的结果； 2）描述SMM行为的经验身体虚弱的成年人患有HF； 3）确定身体脆弱和非物理上的SMM行为需求脆弱的成年人患有HF。完成这项最先进的研究是对开发更大的建议。具体而言，这将使我们的团队能够合并我们对身体脆弱的理解从生物学的角度，具有行为的角度，以发展生物行为干预措施减轻与HF中身体虚弱相关的患者报告和临床结果的不利。