This K-23 award will provide an opportunity for Dr. Kross to become an independent physician scientist focused on improving long-term outcomes for patients with acute lung injury. Through her patient-oriented research proposal, Dr. Kross will identify modifiable critical care risk factors for psychological and functional morbidity among patients with acute lung injury and their family members. Importantly, in order to develop innovative approaches for intervention, she will also evaluate a novel hypothesis of psychological and functional morbidity shared between patients experiencing critical illness and critical care therapies and their families. With the goal of developing a career studying therapies and outcomes for patients with acute lung injury, as well as their families, Dr. Kross proposes an integrated curriculum consisting of practical experience in designing, conducting and publishing clinical research projects;coursework in epidemiology, biostatistics and health services research;and intensive mentoring by experts in the psychological and functional outcomes of critical illness. Dr. Kross will use this K23 award to become an independently funded clinical investigator with skills in the design and conduct of clinical studies of patients with acute lung injury and their families. Moreover, she will develop expertise in survey-based outcome assessment, standardized medical record abstraction, clustered and longitudinal statistical methods, and qualitative data collection and analysis. This career development plan will lead to a successful and independent research career focused on understanding and improving long-term outcomes of acute lung injury. To achieve these goals Dr. Kross will conduct a prospective cohort study to: 1) identify associations between modifiable critical care predictors of psychological and functional morbidity for patients with acute lung injury;2) identify associations between modifiable critical care predictors of psychological and functional morbidity for families of patients of acute lung injury;3) identify associations between psychological and functional morbidity for patients surviving acute lung injury and psychological and functional morbidity for their families;and 4) use qualitative methods to explore potential critical care approaches to interventions that will improve long-term outcomes for patients and their families. This project has important implications for patients with acute lung injury and their families. The identification of modifiable critical care risk factors for long-term psychological symptoms and decreased functional status for both patients with acute lung injury and their families will inform the development of future critical care interventions to reduce these consequences of acute lung injury.

Public Health Relevance

Acute lung injury is a common syndrome of critical illness in the United States. While morbidity is high, the majority of patients with acute lung injury will survive their illness, and, therefore, the long-term consequences of this illness become important. This project has the goal of better understanding the risk factors for long-term psychological symptoms and decreased quality of life among patients with acute lung injury and their family members, and informing the development of interventions that will decrease psychological symptoms and improve quality of life of patients with acute lung injury and their families. (End of Abstract)

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HL098745-05
Application #
8683215
Study Section
Special Emphasis Panel (ZHL1)
Program Officer
Colombini-Hatch, Sandra
Project Start
2010-07-01
Project End
2015-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
5
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Washington
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
Seattle
State
WA
Country
United States
Zip Code
98195
Kross, Erin K (2015) The importance of caregiver outcomes after critical illness. Crit Care Med 43:1149-50
Long, Ann C; Kross, Erin K; Davydow, Dimitry S et al. (2014) Posttraumatic stress disorder among survivors of critical illness: creation of a conceptual model addressing identification, prevention, and management. Intensive Care Med 40:820-9
Long, Ann C; Engelberg, Ruth A; Downey, Lois et al. (2014) Race, income, and education: associations with patient and family ratings of end-of-life care and communication provided by physicians-in-training. J Palliat Med 17:435-47
Kross, Erin K; Engelberg, Ruth A; Downey, Lois et al. (2014) Differences in end-of-life care in the ICU across patients cared for by medicine, surgery, neurology, and neurosurgery physicians. Chest 145:313-21
Bays, Alison M; Engelberg, Ruth A; Back, Anthony L et al. (2014) Interprofessional communication skills training for serious illness: evaluation of a small-group, simulated patient intervention. J Palliat Med 17:159-66
DeCato, Thomas W; Engelberg, Ruth A; Downey, Lois et al. (2013) Hospital variation and temporal trends in palliative and end-of-life care in the ICU. Crit Care Med 41:1405-11
Parsons, Elizabeth C; Kross, Erin K; Ali, Naeem A et al. (2013) Red blood cell transfusion is associated with decreased in-hospital muscle strength among critically ill patients requiring mechanical ventilation. J Crit Care 28:1079-85
Kross, Erin K; Curtis, J Randall (2012) ICU clinicians' perceptions of appropriateness of care and the importance of nurse-physician collaboration. Arch Intern Med 172:889-90
Kross, Erin K; Curtis, J Randall; Cooke, Colin R (2012) Whom should we rely on when assessing symptoms of critically ill patients? Crit Care Med 40:2899-900
Kross, Erin K (2012) Do physicians' beliefs influence treatment options at the end of life? Intensive Care Med 38:1586-7

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