Temporal trends in quality indicators of palliative care for patients with chronic illness hospitalized with acute respiratory failure

因急性呼吸衰竭住院的慢性病患者姑息治疗质量指标的时间趋势

基本信息

批准号：
10622756
负责人：
Jamie Treadway Nomitch
金额：
$ 8.35万
依托单位：
UNIVERSITY OF WASHINGTON
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：
2023-05-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10622756
关键词：
Acute respiratory failure Adult Biostatistical Methods COVID-19 COVID-19 pandemic COVID-19 patient Caring Chronic Chronic Disease Chronically Ill Clinical Communication Consensus Consultations Data Electronic Health Record Emotional Epidemiologic Methods Evolution Face Family Family member Funding Goals Healthcare Systems Home Hospital Mortality Hospitalization Hospitals Intervention Knowledge Life Malignant Neoplasms Measurable Mechanical ventilation Mentors Mentorship Morbidity - disease rate National Heart, Lung, and Blood Institute Outcome Outcomes Research Pain Measurement Palliative Care Patient Care Patient-Focused Outcomes Patients Pattern Physicians Population Process Publications Quality Indicator Quality of life Records Research Research Personnel Respiratory Failure Spirituality Stress Structure Survivors Symptoms Time Time trend United States United States National Institutes of Health care delivery care outcomes cohort current pandemic effective intervention end of life care experience high risk hospital readmission improved medical specialties mortality mortality risk pandemic disease patient population physical symptom post-pandemic pre-pandemic primary outcome psychologic skill acquisition therapy design trend

项目摘要

PROJECT SUMMARY/ABSTRACT Patients with chronic illness who develop acute respiratory failure face significant morbidity and mortality, with survivors often suffering serious physical and psychological sequelae. These patients have a critical need for palliative care. Palliative care is focused on improving quality of life for both patients and family of patients with serious illness by providing high-quality communication, symptom control, and emotional and spiritual support. Despite how important this type of care is, there is little information available regarding the quality of palliative care provided to chronically ill patients with acute respiratory failure. Without this knowledge, it is extremely challenging to develop effective interventions to enhance patient- and family-centered outcomes for this population. To fill this key knowledge gap, I will use explicitly defined, measurable items that detail the processes, outcomes, and structure of palliative care to achieve my primary objective of examining temporal trends in palliative care over the last decade, including an assessment of changes that have occurred since the inception of the COVID-19 pandemic. I have identified a cohort of over 16,000 patients with chronic, life-limiting illness hospitalized with acute respiratory failure between 2012 and 2022. Using this cohort, I will achieve my primary objective through two specific aims. Aim 1 will examine temporal trends in quality indicators of palliative care for patients with chronic illness hospitalized with acute respiratory failure between 2012-2022. Aim 2 will assess differences in quality indicators of palliative care for patients with chronic illness hospitalized with acute respiratory failure, comparing patients with COVID-19 to those without COVID-19, between 2020- 2022. By accomplishing the proposed aims, I will identify improvement, stagnation, and decline in care over time in specific process and outcome metrics across multiple palliative care domains, highlighting significant changes occurring during the COVID-19 pandemic and identifying differences in quality indicators of palliative care for those with and without COVID-19. Results from the proposed project will inform my future research to describe mechanisms underlying these trends, with the goal of developing effective interventions to improve care delivery for adults with chronic, life-limiting illness and acute respiratory failure.

项目概要/摘要患有急性呼吸衰竭的慢性病患者面临着显着的发病率和死亡率，其中幸存者常常遭受严重的身体和心理后遗症。这些患者迫切需要姑息治疗。姑息治疗的重点是改善患者及其家属的生活质量通过提供高质量的沟通、症状控制以及情感和精神支持来治疗严重疾病。尽管这种类型的护理非常重要，但有关姑息治疗质量的信息却很少为患有急性呼吸衰竭的慢性病患者提供护理。如果没有这些知识，那是极其制定有效的干预措施来增强以患者和家庭为中心的结果具有挑战性人口。为了填补这个关键的知识空白，我将使用明确定义的、可衡量的项目来详细说明流程，姑息治疗的结果和结构，以实现我检查时间趋势的主要目标过去十年的姑息治疗，包括对自改革开放以来发生的变化的评估 COVID-19 大流行的开始。我已经确定了超过 16,000 名患有慢性、限制生命的患者的队列 2012 年至 2022 年间因急性呼吸衰竭住院。利用这个队列，我将实现我的目标通过两个具体目标实现主要目标。目标 1 将检查质量指标的时间趋势 2012 年至 2022 年间，对因急性呼吸衰竭住院的慢性病患者进行姑息治疗。目标 2 将评估住院慢性病患者姑息治疗质量指标的差异患有急性呼吸衰竭，将 2020 年至 2022 年。通过实现拟议的目标，我将识别随着时间的推移护理的改善、停滞和下降跨多个姑息治疗领域的具体流程和结果指标，突出了重大变化发生在 COVID-19 大流行期间，并确定姑息治疗质量指标的差异患有和未患有 COVID-19 的人。拟议项目的结果将为我未来的研究提供信息，以描述这些趋势背后的机制，旨在制定有效的干预措施以改善护理为患有慢性、危及生命的疾病和急性呼吸衰竭的成年人提供分娩服务。