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Principal Investigator: Diana Bouhassira
Organization: JOHNS HOPKINS UNIVERSITY
Fiscal Year: 2024
Award: $102,932
Funding agency: National Heart Lung and Blood Institute
PROJECT SUMMARY/ABSTRACT
In-hospital mortality rates for acute respiratory failure (ARF) have improved, resulting in increasing numbers of
ARF survivors. While their survival is indicative of major clinical advances in care, many of these individuals are
left with long-term physical, cognitive, and psychological sequelae of their critical illness, leading to reduced
quality of life (QoL). Interventions in the post-intensive care unit (ICU) setting have struggled to make headway
on improving QoL and there is an urgent need to understand relevant modifiable factors. Evidence suggests that
health expectations and bothersome levels of uncertainty about future health are two such factors. The unifying
goal of this proposal is to understand key factors associated with bothersome uncertainty and expectation
formation in ARF survivors at hospital discharge, as these factors are potential targets for intervention.
We will study a cohort of 65 ARF survivors to characterize the prevalence of bothersome uncertainty and test
the hypothesis that it is associated with perceived quality of healthcare provider communication (Aim 1). We will
also perform at least 25 semi-structured interviews with a purposively selected cohort to further elucidate the
experiences which shaped ARF survivors’ level of uncertainty and identify the sources of information that most
influenced their expectations (Aim 2). This work will be performed leveraging resources allocated to an existing
parent study (1R01HL163660), to ensure feasibility and success within the time period described in this proposal.
This work will fill a gap in knowledge about how bothersome uncertainty and health expectations develop at the
time of hospital discharge after ARF. The results will be applicable to the development of post-ICU interventions
addressing expectations and uncertainty. This study will provide the applicant with essential preliminary data for
a future K-level grant and necessary training in clinical and qualitative research skills including conduct of a
cohort study, collection of patient-reported outcomes, statistical analysis of quantitative data, and conduct and
analysis of qualitative semi-structured interviews. This work will be foundational for the applicant’s long-term goal
of becoming an independently funded clinician investigator working to improve the care of patients in the ICU.
Terms: <21+ years old><Acute respiratory failure><Address><Adult><Adult Human><Adverse effects><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Cancer Patient><Cancers><Caring><Characteristics><Clinical><Clinical Research><Clinical Study><Cognitive><Cohort Studies><Collection><Concurrent Studies><Critical Illness><Critically Ill><Data><Death Rate><Decision Making><Development><Disabling><Ensure><Funding><Future><Goals><Grant><Health><Health Care Providers><Health Personnel><Healthcare><Healthcare Providers><Healthcare worker><Hospital Mortality><Hospitals><Illness impact><In-house Mortalities><Individual><Influentials><Inhospital Mortality><Injury><Inpatients><Intensive Care Units><Intervention><Intervention Strategies><Interview><Investigators><Knowledge><Learning><Left><Malignant Neoplasms><Malignant Tumor><Measures><Mediator><Mentors><NHLBI><National Heart, Lung, and Blood Institute><Palliative Care><Palliative Therapy><Palliative Treatment><Parents><Participant><Patient Care><Patient Care Delivery><Patient Outcomes Assessments><Patient Reported Measures><Patient Reported Outcomes><Patients><Perception><Population><Population Sizes><Predisposing Factor><Prevalence><Process><QOL><Qualitative Methods><Qualitative Research><Quality of life><Recovery><Reporting><Research><Research Infrastructure><Research Personnel><Researchers><Resource Allocation><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Shapes><Source><Statistical Data Analyses><Statistical Data Analysis><Statistical Data Interpretation><Structure><Survivors><Testing><Time><Training><Uncertainty><United States><Work><adulthood><care for patients><care of patients><caring for patients><clinician communication><cohort><comfort care><communicate to clinicians><communicate to providers><communicate with clinicians><communicate with doctors><communicate with providers><coping><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><design><designing><developmental><doctor communication><doubt><expectation><experience><health assessment><health care><health care personnel><health care quality><health care worker><health provider><health workforce><healthcare personnel><healthcare quality><improved><injuries><interventional strategy><long-term sequelae><malignancy><medical personnel><mortality rate><mortality ratio><neoplasm/cancer><novel><observational cohort study><parent><physical impairment><provider communication><psychologic><psychological><qualitative reasoning><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><skills><statistical analysis><success><treatment provider>