PatientswithCOPDhaveahighburdenofillnessandpoorqualityoflife.Despiteclearevidencethatsuch patientsfrequentlylackengagementinhealth-promotingbehaviorsandtendtode-valuefuturehealth consequences,almostnoworkhasinvestigatedwhetherthesepatientsmakepredictiveerrorsaboutfuture healthstatesnorinvestigatedtheassociationofsucherrorsonfuturehealth-relatedqualityoflife(HRQL).The proposedstudy?sbroadobjectiveistoimprovetheoutcomesofpatientswithCOPD.Thecandidate?s completedNHLBIF32-fundedstudyofpatientswithsmoking-associatedpulmonarydiseasesgenerateda conceptualframeworkthatformsthefoundationfortheproposedwork.Shehascontinuedtopreparefor scientificindependencethroughanNHLBIK12thatexplorestheacceptabilityandcompetencyofspecific attributesofphysician-patientcommunication(e.g.,choicearchitectureandtheuseofbeneficentdeception). Theproposedstudybuildsuponthesefindingsandseeksto1)assesstheaccuracywithwhichpatientswith severeCOPDpredicttheirfuturehealthstates,2)evaluatetherelationshipbetweenaccuracyofexpectations andpatient-reportedHRQL,and3)explorehowpatientswithdifferingexpectationsandpredictiveaccuracy generatetheirpredictionsandengageinprospection.Thestudywillinvolvealongitudinalprospectivecohort studyenrolling207patientswithsevereCOPD.Participantswillcompletebaselinemeasurementsofindividual characteristics(selectedfrompreliminarydataandapplicabletheories)andmeasuresofHRQL.Participants will,atthetimeofenrollment,providepredictionsoftheirdyspneaandemotionalsymptomsfor3and12 monthsinthefuture.Eachpatient?saccuracywillbedeterminedbycomparinghisorherindividualpredictions toexperiencedsymptomsatthesefollow-upintervals.Completionofthisresearchwillbuilduponthe candidate?spasttraininganduninterruptedNHLBIsupport,whichincludesaMastersinHealthPolicy ResearchobtainedwithNHLBIT32support,andF32andK12periods,andwillprovidetheexperience, education,andmentorshiptoallowthecandidatetobecomeafullyindependentinvestigator.Thecandidate?s rigoroustrainingplan,focusedonobtainingadvancedskillsinbehavioralscienceandpatient-centered outcomesresearchandexpertiseinprospectivestudies,willallowhertosubmitsuccessfulR01orPCORI applicationstestinginterventionsdevelopeddirectlyfromtheresultsofthiswork.Thecandidate?sprimary mentor,co-mentor,collaborators,andadvisorswillensureadherencetotheproposedtimelineandgoalsand provideasupportiveenvironmentforhertodevelopanindependentresearchcareerinvestigatingdecision interventionsthatimprovehealthoutcomesamongpatientswithCOPD.
Smoking causes lung diseases such as chronic obstructive pulmonary disease and lung cancer, leading to suffering among affected patients. Helping patients think clearly about their expectations for the future may help them choose the best treatments for them, cope with their illness, and prepare for likely outcomes. The aim of this research is to provide new knowledge about the accuracy of such patients' predictions and the role of expectations in determining patients' well being in order to improve patients' quality of life.
