Communication Quality and Patient Outcomes in HIV/AIDS and Substance Abuse

艾滋病毒/艾滋病和药物滥用方面的沟通质量和患者结果

• 批准号: 9000684
• 负责人: MARY CATHERINE BEACH
• 金额: $ 18.47万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9000684
• 关键词: AIDS/HIV problem; Address; Adherence; Anti-Retroviral Agents; Attention; Award; Caring; Clinical; Clinical Research; Communication; Counseling; Day Care; Discourse analysis; Drug abuse; Drug usage; Epidemiologic Studies; Faculty; Goals; HIV; Health; Health Professional; Healthcare; High Prevalence; Internal Medicine; Lead; Life; Logic; Medical; Medicine; Mentors; Mentorship; Mid-Career Clinical Scientist Award (K24); Midcareer Investigator Award in Patient-Oriented Research; Mining; Oral cavity; Outcome; Patient-Focused Outcomes; Patients; Pattern; Perception; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pharmacotherapy; Physicians; Population; Postdoctoral Fellow; Prevention Research; Professional counselor; Provider; Qualitative Research; Quality of Care; Recommendation; Recovery; Reporting; Research; Research Personnel; Sampling; Scholarship; Students; Substance abuse problem; Techniques; Therapeutic; Thinking; Time; Training; Treatment outcome; Twin Multiple Birth; Universities; Visit; Work; behavior change; career; evidence base; experience; health care quality; improved; medical schools; mid-career faculty; mindfulness; motivational enhancement therapy; patient oriented research; programs; sociolinguistics; substance abuse treatment; systematic review

 DESCRIPTION (provided by applicant): This is a proposal for a K24 Midcareer Investigator Award in Patient-oriented Research for Mary Catherine Beach, MD, MPH of the Johns Hopkins University School of Medicine. Dr. Beach is an Associate Professor of Medicine in the Division of General Internal Medicine and Core Faculty in the Welch Center for Prevention, Epidemiology and Clinical Research. Dr. Beach has spent the majority of her career and scholarship over the past 10 years focusing on patient-oriented research in populations with a high prevalence of substance abuse (or perception of substance abuse) that negatively impacts quality of care and health outcomes. Despite a well- established evidence base that high-quality respectful patient-clinician communication and relationships are critically important to patient outcomes, there are wide gaps in our current understanding of patient-clinician communication in the treatment of HIV/AIDS and drug abuse. One recent systematic review determined that therapeutic alliance between patient and counselor was most important in predicting drug treatment outcomes but little is known about how a therapeutic alliance is built in medical settings between physicians and patients with active drug use. This K24 award will protect time for the applicant to mentor junior investigators and conduct significant original research aimed at improving communication and relationships between clinicians and patients with substance abuse. The aims of the original research are: (1) to explore the quality of provider counseling about substance abuse treatment within routine ambulatory primary HIV care encounters, identify reasons for missed opportunities for counseling, identify correlates of higher quality counseling, and prioritize recommendations for provider training, (2) To discover, using the sociolinguistic technique of conversation analysis, which patterns of asking about and addressing anti-retroviral adherence are most reliable and effective in clinical encounters among HIV-infected patients with substance abuse, and (3) to analyze the vocal tone on a sample of audio-recorded encounters and examine whether higher levels of respectfulness and warmth as rated by independent observers predict continued patient engagement in care among HIV-infected patients with substance abuse. These aims will be addressed in the context of providing mentorship to new and existing junior faculty, post-doctoral fellows and students. The K24 will allow Dr. Beach to more effectively pursue her long-term career goals to enhance respect, to improve communication, and to better the patients' experiences, all for the purpose of reducing suffering and improving health and well-being of these underserved and stigmatized populations.

 描述（由应用程序提供）：这是为K24中级护理调查员奖的提案，该奖项是约翰·霍普金斯大学医学院Mary Catherine Beach，Mary Catherine Beach，Mary Catherine Beach，Mary Catherine Beach。 Beach博士是韦尔奇预防，流行病学和临床研究中心的通用内科和核心教师的医学副教授。在过去的10年中，Beach博士在她的职业生涯和奖学金中度过了大部分时间，重点关注以患者为导向的研究，这些研究高于滥用药物（或对药物滥用的感知），这会对护理和健康成果的质量产生负面影响。尽管有一个有证据表明，高质量尊重的患者 - 阵容沟通和关系对患者的结局至关重要，但我们目前对患者 - 痛苦的艾滋病毒/艾滋病和药物滥用方面的患者 - 阵线交流的理解却很大。最近的一项系统评价确定，患者和辅导员之间的治疗联盟对于预测药物治疗结果最为重要，但是对于如何在医师和有活跃药物使用的患者之间建立治疗联盟，对治疗联盟的建立知之甚少。该K24奖将保护申请人的精神初级调查员的时间，并进行针对的重大原始研究 改善临床医生与滥用毒品的患者之间的沟通和关系。最初研究的目的是：（1）探索提供者咨询有关常规卧床艾滋病毒抗药性治疗的提供者咨询的质量在艾滋病毒感染的患者中遭受滥用药物的遭遇，以及（3）分析音频录制相遇样本的声音，并检查独立观察家对较高的尊重和温暖水平是否预测，预测患者在艾滋病毒感染的患者中持续参与患者的药物滥用患者。这些目标将在为新的和现有的初级教职员工，博士后研究员和学生提供指导的背景下解决。 K24将使Beach博士能够更有效地追求她的长期职业目标，以增强尊重，改善沟通和改善患者的经历，以减少苦难，改善这些服务不足和污名化的人群的健康和福祉。