The candidate's research interests encompass developing and evaluating patient-centered treatment approaches designed to facilitate engagement in rehabilitation therapies, in order to positively affect psychological and quality of life outcomes in adults surviving critical illness. Her short-term career goal is to conduct mentored research with guidance and expertise provided by leaders in the field of physical medicine and rehabilitation for critically ill and injured patients (Drs. Needham and Wegener). Her long-term career goal is to become an independent clinical researcher conducting patient-oriented research that is focused on developing, evaluating, and implementing psychological interventions to improve short- and long-term outcomes after critical illness. To reach this career goal, the candidate needs additional specialized training in several key areas to address important gaps in her training. Through mentorship, focused coursework in clinical research methods, grantsmanship workshops, and training in the ethical conduct of research, she will develop a solid foundation to build her career as an independent, patient-oriented clinical researcher. Formal training in advanced epidemiological methods, study design, and associated biostatistics will occur through didactic course work at the Johns Hopkins Bloomberg School of Public Health (JHSPH);an NIH-sponsored summer institute on Randomized Behavioral Clinical Trials;a 5-day intensive workshop on grant writing for rehabilitation research;attendance and presentations at annual scientific conferences;and attendance at the monthly Johns Hopkins Physical Medicine and Rehabilitation grand rounds. In addition, this learning will be reinforced and applied as part of regular mentoring meetings with Drs. Needham and Wegener who have relevant expertise and experience in clinical research methods in the candidate's field of study. The candidate will also have access to additional epidemiology and biostatistics faculty members who are part of Dr. Needham's Outcomes after Critical Illness and Surgery (OACIS) Research group. To improve anxiety management in critically ill patients participating in early rehabilitation therapies in the intensive care unit, the candidate plans to conduct a randomized controlled double-blinded pilot trial of a novel psychologist-administered intervention. The overall goal of this research is to improve the management of anxiety in critically ill patients participating in early rehabilitation therapies. Symptoms of anxiety, and current ICU anxiety management strategies, may be associated with worse psychological outcomes after hospital discharge. Evaluating the adverse effects of anxiety symptoms in the ICU, and the potential benefits of a novel anxiety management intervention is innovative and important for improving patient outcomes. The scientific disciplines and research areas encompassed by the proposed study will be multidisciplinary to include physical medicine and rehabilitation, rehabilitation psycholog, critical care and pulmonary medicine, physical therapy, occupational therapy, and nursing care specialties.
The number of survivors of critical illness is large and rapidly increasing due to the aging population, increasing intensive care unit (ICU) demand, and improving ICU mortality rates. Anxiety is a common psychological issue experienced by patients during and after intensive care. This research will create new knowledge regarding the impact of anxiety on patient recovery after critical illness and will evaluate the effect of a novel psychologist-administered anxiety treatment approach in the ICU on patients'engagement in rehabilitation while hospitalized, and on psychological recovery and quality of life after critical illness.