A Digital Serious Illness Conversation Coach

数字重病对话教练

基本信息

批准号：
10759161
负责人：
Y. Xian Ho
金额：
$ 27.49万
依托单位：
DIMAGI, INC.
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：
2023-09-30 至 2024-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10759161
关键词：
Address Adoption Adult Anxiety Benchmarking Caring Cessation of life Chronic Disease Communication Decision Making Development Diagnosis Educational Intervention Effectiveness Enrollment Feedback Frequencies Future Goals Health Professional Heart Diseases Industry Standard Intervention Interview Knowledge Learning Learning Skill Life Logic Logistics Lung diseases Malignant Neoplasms Managed Care Modeling Nurses Oncology Outcome Measure Palliative Care Patient Care Patients Phase Physicians Pilot Projects Primary Care Process Quality of life Randomized, Controlled Trials Recommendation Role Sampling Small Business Innovation Research Grant Social Workers Structure Surveys System Technology Testing Training United States United States National Institutes of Health Ventilator Work acceptability and feasibility career chatbot cost effective cost effectiveness design digital disability effectiveness evaluation end of life end of life care experience follow-up health training human centered design implementation study improved medical specialties novel preference programs promoter prototype psychological distress satisfaction skills usability

项目摘要

PROJECT SUMMARY It has been shown that conversations on end-of-life care focused on a patient’s goals of care can reduce psychological distress and anxiety and lead to improved quality of life, and potentially prolonged life, for patients living with serious illness. The Serious Illness Conversation Guide (SICG) is a validated and widely used framework for training the critical communication skills needed to effectively conduct these conversations; however, there currently exists no mechanism to easily support and continue to build these skills in a scalable way. Evidence suggests that conversational agents, i.e., chatbots, can be used for training and reinforcing communication skills. In this Phase I SBIR project, we propose to optimize and assess the feasibility and acceptability of a chatbot designed to augment SICG training for healthcare professionals (HCPs) on initiating and conducting sensitive conversations with patients diagnosed with serious illness. We will develop and test a chatbot directly with HCPs who are navigating serious illness conversations and/or may be expected to in the future. We will demonstrate feasibility and acceptability of an enhanced chatbot prototype through the following two specific aims: In Aim 1, we will create and adapt chatbot content and build an enhanced, fully functional prototype of the chatbot with expert inputs. The chatbot will feature 3 different patient scenarios ranging in case complexity. In Aim 2, we will conduct a pilot usability study of the prototype with 50 target end users—a diverse sample of HCPs varying in role, specialty, and career phase who have received at least one training session in the SICG. Following enrollment, HCPs will independently test the chatbot-led training and complete surveys at 3 timepoints—baseline, endline, and 1-month after enrollment—to assess the following outcome measures: pre-/post-training confidence in having serious illness conversations, usability, and user satisfaction. Semi-structured endline interviews will be conducted with a purposive sample of 15-20 HCPs to collect additional qualitative feedback on user experience and recommendations for improvement. Results of this Phase I SBIR project will inform a larger scale implementation study in potential Phase II work to evaluate the effectiveness and cost-effectiveness of the proposed intervention to reinforce and augment critical communication skills essential to the care of seriously ill patients.

项目概要研究表明，有关临终关怀的对话重点关注患者的护理目标可以减少心理困扰和焦虑，提高生活质量，并且对于患有严重疾病的患者来说，可能会延长生命。对话指南 (SICG) 是一个经过验证且广泛使用的框架，用于培训关键技能然而，有效进行这些对话所需的沟通技巧；目前不存在任何机制可以轻松支持并继续以可扩展的方式培养这些技能有证据表明，对话代理（即聊天机器人）可用于培训和在第一阶段 SBIR 项目中，我们建议优化和加强沟通技巧。评估旨在增强 SICG 培训的聊天机器人的可行性和可接受性医疗保健专业人员 (HCP) 发起并进行敏感对话我们将直接与 HCP 一起开发和测试聊天机器人。正在讨论严重疾病的人和/或将来可能会这样做的人。将通过以下方式展示增强型聊天机器人原型的可行性和可接受性以下两个具体目标：在目标 1 中，我们将创建和调整聊天机器人内容，并构建一个带有专家输入的增强型全功能聊天机器人原型该聊天机器人将具有 3 个功能。在目标 2 中，我们将进行试点可用性。对 50 名目标最终用户的原型进行研究——角色不同的不同 HCP 样本，在 SICG 中至少接受过一次培训课程的专业人士和职业阶段人士。注册后，HCP 将独立测试聊天机器人主导的培训并完成在 3 个时间点（基线、终点和入组后 1 个月）进行调查，以评估以下结果衡量标准：培训前/培训后对患有严重疾病的信心对话、可用性和用户满意度将是半结构化的终端访谈。对 15-20 名 HCP 进行了有目的的抽样，以收集关于以下方面的更多定性反馈：第一阶段 SBIR 项目的用户体验和改进建议。将为潜在的第二阶段工作中更大规模的研究实施提供信息，以评估拟议干预措施的有效性和成本效益，以加强和增强关键的沟通技巧对于重症患者的护理至关重要。