Center for Improving Palliative Care for Vulnerable Adults with MCC (CIPC)

改善 MCC 弱势成人姑息治疗中心 (CIPC)

基本信息

批准号：
9605905
负责人：
Jingjing Shang
金额：
$ 41.8万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
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：
2018-08-08 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9605905
关键词：
Acculturation Acute Address Adult Age Area Behavioral Model Biometry Caring Characteristics Chronic Common Data Element Communication Compassion Consultations Coupled Ecology Effectiveness End stage renal failure Ensure Environment Ethnic Origin Face Foundations Funding Future Geographic Locations Health Health Services Health behavior Hospitalization Interdisciplinary Study Knowledge Life Location Logic Medical Methods Modeling National Institute of Nursing Research New York Nurses Nursing Homes Nursing Services Outcome Output Palliative Care Patients Pattern Pilot Projects Population Principal Investigator Procedures Process Quality of life Race Research Research Infrastructure Research Methodology Research Personnel Resource Sharing Risk School Nursing Science Scientist Self Management Services Sex Orientation Socioeconomic Status Training Universities Visiting Nurse Vulnerable Populations base biobehavior care coordination formative assessment health care service utilization health care settings high risk hospice environment improved innovation meetings multilevel analysis multiple chronic conditions patient population preference programs satisfaction skills symptom management urban dwelling

项目摘要

Multiple chronic conditions (MCC), defined as two or more co-occurring chronic conditions, occur frequently in vulnerable adult patients such as those living in nursing homes or with end-stage renal disease. Vulnerable adult populations with MCC have worse health outcomes and higher utilization of all types of health services compared to those who do not have chronic conditions, and they are at higher risk of receiving inappropriate and/or burdensome services (e.g., procedures, treatments, and hospitalizations) that are inconsistent with their preferences. Medical complexity alone does not explain these differences; the issues vary on many characteristics including race/ethnicity, acculturation, and living location. Furthermore, while most palliative care is currently provided in acute care, it is recommended that interdisciplinary palliative care begin early for any serious illness and be delivered across the continuum of health care settings. There are knowledge gaps in key palliative care areas including how best to support symptom management, communication, and care coordination; these knowledge gaps must be addressed to provide effective innovative interdisciplinary care models in multiple health care settings for vulnerable adult patients with MCC to ensure they receive appropriate care that is consistent with their preference . To address these gaps, the aims of the exploratory P20 Center for Improving Palliative Care for Vulnerable Adults with MCC (CIPC) are to: 1) Develop a sustainable infrastructure that supports interdisciplinary researchers to develop into transdisciplinary teams that conduct biobehavioral, palliative care research across health care settings for vulnerable adults with MCC; 2) Develop new programs of biobehavioral, palliative care research for vulnerable adults with MCC led by nurse scientists; 3) Enhance the knowledge and skills of participating investigators on transdisciplinary, biobehavioral, palliative care research methods across health care settings for vulnerable adults with MCC and disseminate new knowledge to relevant stakeholders; and 4) Evaluate the Center's inputs, outputs, and outcomes on an ongoing and annual basis and refine processes as needed. The CIPC is uniquely poised to develop research capacity in this area. The partnership between Columbia University School of Nursing and the Visiting Nurse Service of New York increases access of pilot project investigators to vulnerable urban dwelling adults with MCC. The Enrichment Plan activities, which are informed by leading interdisciplinary palliative care clinicians, along with support from the Pilot Administrative Core with vast scientific expertise (e.g., mixed methods biobehavioral research in adults with MCC and biostatistics) and expert consultation with the Palliative Care Research Cooperative, provide an excellent foundation in best practices for biobehavioral, palliative care research. This foundation coupled with the robust research environment and strong Administrative Core increases the likelihood of the CIPC meeting its important aims which are consistent with NINR's strategic theme “End-of Life and Palliative Care: The Science of Compassion”.

多种慢性病 (MCC) 定义为两种或两种以上同时发生的慢性病，经常发生在弱势成年患者，例如居住在疗养院或患有终末期肾病的患者。患有 MCC 的成年人的健康状况较差，对各类医疗服务的利用率较高与那些没有慢性病的人相比，他们接受不适当治疗的风险更高和/或与他们的要求不一致的繁重服务（例如手术、治疗和住院）医疗复杂性本身并不能解释这些差异；问题因人而异。此外，还包括种族/民族、文化适应和居住地点等特征，但大多数都是姑息治疗。目前提供急性护理，建议尽早开始跨学科姑息治疗任何严重疾病并在整个医疗保健机构中提供服务存在知识差距。在关键的姑息治疗领域，包括如何最好地支持症状管理、沟通和护理协调；必须解决这些知识差距，以提供有效的创新跨学科护理在多个医疗机构中为患有 MCC 的弱势成年患者建立模型，以确保他们接受为了解决这些差距，探索性的目的是提供符合他们偏好的适当护理。 P20 改善 MCC 弱势成人姑息治疗中心 (CIPC) 将： 1) 制定支持跨学科研究人员发展成为跨学科团队的可持续基础设施在整个医疗保健环境中为患有 MCC 的弱势成年人开展生物行为、姑息治疗研究； 2) 为患有 MCC 的弱势成年人制定新的生物行为、姑息治疗研究项目，由 3）提高参与研究人员的跨学科知识和技能；针对患有 MCC 的弱势成年人的生物行为、姑息治疗研究方法向相关利益相关者传播新知识；以及 4) 评估中心的投入、产出和 CIPC 具有独特的优势，能够持续每年取得成果并根据需要改进流程。发展该领域的研究能力。纽约的访问护士服务增加了试点项目调查员接触弱势城市的机会 MCC 的丰富计划活动由领先的跨学科人士提供信息。姑息治疗赞助者，以及具有丰富科学专业知识的试点管理核心的支持（例如，对患有 MCC 的成人进行生物行为研究和生物统计学的混合方法）以及专家咨询姑息治疗研究合作社，为生物行为的最佳实践提供了良好的基础，这个基础加上强大的研究环境和强大的姑息治疗研究。行政核心增加了 CIPC 实现其重要目标的可能性，这些目标与 NINR 的战略主题是“临终关怀和姑息治疗：同情的科学”。