Improving Care at the End of Life for Latinos:A Cultural Navigator Intervention

改善拉丁裔临终关怀：文化导航干预

• 批准号: 7879935
• 负责人: STACY M FISCHER
• 金额: $ 18.14万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-15 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7879935
• 关键词: Address; Advance Care Planning; Advance Directives; Advanced Malignant Neoplasm; Age; Age-Years; Aged, 80 and over; Area; Behavioral Sciences; Cancer Intervention; Caring; Cessation of life; Chronic; Clinical Research; Colorado; Commit; Communities; Community Health; Community Participation; Control Groups; Data; Development; Doctor of Philosophy; Effectiveness of Interventions; Elderly; Environment; Ethnic group; Failure; Family; Fellowship Program; Funding; Goals; Grant; Health Services Research; Health Services for the Aged; Hospice Care; Institution; Internal Medicine; Intervention; Intervention Studies; K-Series Research Career Programs; Latino; Lead; Life; Measurement; Mentorship; Methodology; Methods; Outcome; Outcome Measure; Pain management; Palliative Care; Patient Education; Patients; Persons; Phase; Population; Primary Health Care; Process; Provider; Publishing; Quality of life; Randomized; Randomized Controlled Trials; Research; Research Personnel; Resources; Sample Size; Services; Testing; Time; Training; Underserved Population; United States; Ursidae Family; Withdrawal; Work; base; care preference; cost; cost effectiveness; cultural values; design; end of life; end of life care; ethnic minority population; experience; health disparity; hospice environment; improved; innovation; meetings; member; older patient; preference; satisfaction; symptom management; therapy design; treatment as usual

DESCRIPTION (provided by applicant): Candidate: The candidate, Stacy M. Fischer, MD, is committed to becoming an independently-funded researcher in the area of cross-cultural end-of-life care. Her background includes previous work with underserved populations, experience in the clinical and research aspects of end-of-life care, with a specific focus on elderly patients, and training in Internal Medicine and Geriatrics. Currently, Dr. Fischer is supported by the National Brookdale Fellowship Program and an NCI/NIA P20 pilot grant and completing a qualitative and quantitative study of cultural preferences for end-of-life care. The NIA/Beeson K23 Career Development Award will provide her the protected time and the resources to study the efficacy of implementing a cultural navigator intervention designed to improve end-of-life care for elderly Latinos. Environment: The mentorship and institutional resources available to Dr. Fischer are exceptional. Jean Kutner, MD, MSPH, the sponsor, and Andrew Kramer, MD, Al Marcus, PhD, and Angela Sauaia, MD, PhD, the co-sponsors, will impart their respective expertise in end-of-life care, geriatrics, health services research, patient-navigation interventions, behavioral science, and cross-cultural research. Research Plan: The overall goal of the proposed study is to improve end-of-life care for seriously ill older. Latinos through a cultural navigator, or guia, delivering a culturally tailored intervention. The first step of the project is to develop, through a multi-step process involving community members and experts in the field, the materials needed for the intervention and to train the guia. The next phase of the project is a vanguard randomized controlled trial of the cultural navigator intervention, targeting Latinos with advanced cancer. The intervention is designed to assess the feasibility of conducting a fully powered randomized controlled trial of the intervention by determining withdraw rates, and estimating rates of Advance Care Planning, improved pain management, and utilization of hospice care. The proposed study also includes development of a method to assess the cost-effectiveness of the intervention versus usual care.

描述（由申请人提供）： 候选人： 候选人 Stacy M. Fischer，医学博士，致力于成为跨文化临终关怀领域的独立资助研究人员。她的背景包括以前在服务不足的人群中的工作、临终关怀的临床和研究方面的经验（特别关注老年患者）以及内科和老年病学方面的培训。目前，Fischer 博士得到了国家布鲁克代尔奖学金计划和 NCI/NIA P20 试点拨款的支持，并完成了关于临终关怀文化偏好的定性和定量研究。 NIA/Beeson K23 职业发展奖将为她提供受保护的时间和资源，以研究实施旨在改善拉丁裔老年人临终关怀的文化导航干预措施的有效性。环境：费舍尔博士可以获得的指导和机构资源非常出色。 Jean Kutner（医学博士、公共卫生硕士）、发起人、Andrew Kramer（医学博士）、Al Marcus（博士）和 Angela Sauaia（医学博士、哲学博士） 共同发起者将传授各自在临终关怀、老年病学、卫生服务方面的专业知识 研究、患者导航干预、行为科学和跨文化研究。 研究计划：拟议研究的总体目标是改善重病老年人的临终护理。拉丁裔通过文化导航员（guia）提供针对文化的干预措施。该项目的第一步是通过社区成员和该领域专家参与的多步骤过程，开发干预和培训东望洋所需的材料。该项目的下一阶段是文化导航干预的先锋随机对照试验，针对患有晚期癌症的拉丁裔。 该干预措施旨在通过确定退出率、估计预先护理计划、改善疼痛管理和临终关怀的利用率，来评估进行干预措施的全动力随机对照试验的可行性。拟议的研究还包括开发一种方法来评估干预措施与常规护理的成本效益。

项目成果

Reply to Comment on: How U.S. Doctors Die: A Cohort Study of Healthcare Use at the End of Life.

回复评论：美国医生如何死亡：临终医疗保健使用的队列研究。

• 发表时间: 2017-08
• 影响因子: 6.3
• 作者: Fischer, Stacy M;Matlock, Dan D
• 通讯作者: Matlock, Dan D

Advance directive discussions do not lead to death.

预先医疗指示讨论不会导致死亡。

• 发表时间: 2010-02
• 影响因子: 6.3
• 作者: Fischer, Stacy;Min, Sung;Kutner, Jean
• 通讯作者: Kutner, Jean

Advance directive discussions: lost in translation or lost opportunities?

预先指示讨论：在翻译中迷失还是失去机会？

• 发表时间: 2012-01
• 影响因子: 2.8
• 作者: Fischer, Stacy M;Sauaia, Angela;Min, Sung;Kutner, Jean
• 通讯作者: Kutner, Jean

Apoyo con Cariño: a pilot randomized controlled trial of a patient navigator intervention to improve palliative care outcomes for Latinos with serious illness.

Apoyo con Cariño：一项针对患者导航干预的随机对照试验，旨在改善患有严重疾病的拉丁美洲人的姑息治疗结果。

• 发表时间: 2015-04
• 影响因子: 4.7
• 作者: Fischer, Stacy M;Cervantes, Lilia;Fink, Regina M;Kutner, Jean S
• 通讯作者: Kutner, Jean S

How U.S. Doctors Die: A Cohort Study of Healthcare Use at the End of Life.

美国医生如何死亡：临终医疗保健使用的队列研究。

• 发表时间: 2016-05
• 影响因子: 6.3
• 作者: Matlock, Daniel D;Yamashita, Traci E;Min, Sung;Smith, Alexander K;Kelley, Amy S;M Fischer, Stacy
• 通讯作者: M Fischer, Stacy