This application for a T32 predoctoral and postdoctoral training program describes a proposed plan for training in symptom management and palliative care research among adults with advanced disease - specifically cancer, heart failure, and chronic critical illness. The long-term goal of this training program is to train a diverse group nurse scientists who will advance our knowledge and understanding of how to provide effective palliation - - that is, management of symptoms - - that significantly impair quality of life in advanced and incurable disease states. Symptom management investigations are especially challenging in subject populations who have life-limiting, progressive disease, yet these are also the patients usually in greatest need of expert symptom management. In addition to measurement and instrument issues specific to single symptoms (e.g. pain, dyspnea), identifying appropriate end points in the context of disease progression, the high likelihood of missing data from subjects who are quite ill, and accounting for the effects of co-existing depression and anxiety when measuring physical symptoms are common challenges in this population. In order to advance our understanding of symptom management approaches and build the evidence base needed for effective palliative care, specific tailored preparation in methodologies and analytic strategies needed for research with persons with progressive, advanced illness are essential. This training program will address that need. This NRSA will provide support for 8 predoctoral trainees and 9 post-doctoral trainees over the 5 years of the program. In addition to our typical applicant pool, we will particularly target BSN students for entry to the """"""""fast-track"""""""" BSN-to-PhD program and members of minority groups. We have an existing internal program to identify promising BSN students in our school who demonstrate exceptional potential for moving directly in to a doctoral program. Our faculty also have leadership roles in national specialty organizations with large BSN memberships, and these will provide additional recruitment opportunities. Through our existing relationships with several colleges that have large minority student populations, we will be able to target recruitment to achieve a demographic balance in the training program. We have established collaborative relationships with a variety of accomplished researchers from other disciplines who will be active faculty participants on this training program. Both the pre- and postdoctoral training plans are built on a successful record of recruitment and productivity of previous graduates and we believe the focus of the proposed program will enable trainees to make significant contributions to this important area of nursing science.

Public Health Relevance

Effective management of symptoms is a crucial aspect of health care in all illnesses;it is even more important in advanced illness, when quality of life becomes the primary goal. Although there has been a great deal of research in symptom management, investigations in states of advanced disease, such as cancer, heart failure, and critical illness, present particular challenges. The proposed training program will prepare pre- and postdoctoral students with training in the content areas, sophisticated methodologies, and analytic techniques needed to prepare them to make significant contributions to this critical topic.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Institutional National Research Service Award (T32)
Project #
1T32NR014213-01
Application #
8472723
Study Section
Special Emphasis Panel (ZNR1-REV-W (10))
Program Officer
Banks, David
Project Start
2013-07-01
Project End
2018-06-30
Budget Start
2013-07-01
Budget End
2014-06-30
Support Year
1
Fiscal Year
2013
Total Cost
$213,848
Indirect Cost
$12,804
Name
Case Western Reserve University
Department
Type
Schools of Nursing
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Oliveira, Vitor H F; Perazzo, Joseph D; Josephson, Richard A et al. (2018) Association Between the 6-Minute Walk Test Distance and Peak Cardiorespiratory Fitness Among People Living with HIV Varies by Fitness Level. J Assoc Nurses AIDS Care 29:775-781
Moss, Karen O; Deutsch, Nancy L; Hollen, Patricia J et al. (2018) Understanding End-of-Life Decision-Making Terminology Among African American Older Adults. J Gerontol Nurs 44:33-40
Wright, Kathy D; Still, Carolyn H; Jones, Lenette M et al. (2018) Designing a Cocreated Intervention with African American Older Adults for Hypertension Self-Management. Int J Hypertens 2018:7591289
Moss, Karen O; Deutsch, Nancy L; Hollen, Patricia J et al. (2018) End-of-Life Plans for African American Older Adults With Dementia. Am J Hosp Palliat Care 35:1314-1322
Webel, Allison R; Moore, Shirley M; Longenecker, Chris T et al. (2018) Randomized Controlled Trial of the SystemCHANGE Intervention on Behaviors Related to Cardiovascular Risk in HIV+ Adults. J Acquir Immune Defic Syndr 78:23-33
Pignatiello, Grant A; Martin, Richard J; Hickman Jr, Ronald L (2018) Decision fatigue: A conceptual analysis. J Health Psychol :1359105318763510
Pignatiello, Grant A; Tsivitse, Emily; Hickman Jr, Ronald L (2018) A preliminary psychometric evaluation of the eight-item cognitive load scale. Appl Nurs Res 40:99-105
Hickman Jr, Ronald L; Pignatiello, Grant A; Tahir, Sadia (2018) Evaluation of the Decisional Fatigue Scale Among Surrogate Decision Makers of the Critically Ill. West J Nurs Res 40:191-208
Still, Carolyn Harmon; Jones, Lenette M; Moss, Karen O et al. (2018) African American Older Adults' Perceived Use of Technology for Hypertension Self-Management. Res Gerontol Nurs 11:249-256
Jones, Lenette M; Moss, Karen O; Wright, Kathy D et al. (2018) ""Maybe This Generation Here Could Help the Next Generation"": Older African American Women's Perceptions on Information Sharing to Improve Health in Younger Generations. Res Gerontol Nurs 11:39-47

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