NINR-supported researchers explore and address some of the most important challenges affecting the health of the American people. NINR Research Highlights feature research accomplishments from the community of NINR-supported scientists across the U.S.
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A multi-site study of a web-based decision support tool for men newly diagnosed with localized prostate cancer found that the tool helped significantly reduce decisional conflict in choosing treatment options. This tool, the Personal Patient-Profile-Prostate (P3P) decision aid, involved education and communication coaching through text, graphs, and video clips. The study found that the P3P intervention reduced decisional conflict that participants experienced regarding their treatment options during the weeks after their diagnosis, compared to usual care. The study also revealed subtle differences in the level of decisional conflict experienced by participants that were associated with marital status, risk level for poor treatment outcomes, and income. Decision support strategies such as the P3P intervention can help support patients newly diagnosed with localized prostate cancer make what can be difficult choices about their treatment.
Berry DL, Hong F, Blonquist TM, Halpenny B, Filson CP, Master VA, Sanda MG, Chang P, Chien GW, Jones RA, Krupski TL, Wolpin S, Wilson L, Hayes JH, Trinh QD, Sokoloff M, Somayaji P. Decision Support with the Personal Patient Profile-Prostate: A Multicenter Randomized Trial. J Urol. 2018 Jan;199(1):89-97. PMID:28754540
In a retrospective study of births at an academic medical center between 2005 and 2012, researchers supported by NINR and other organizations examined over 3,000 low-risk full-term births by first-time mothers. They found distinct differences between the births overseen by obstetricians and nurse-midwives. First time mothers were found to have more unplanned caesarean sections and labor interventions, including oxytocin use, regional anesthesia use, and delivery with the use of forceps or vacuum, when treated by an obstetrician versus a nurse-midwife. Understanding the differences in labor management style between different groups of clinicians is essential to helping lower caesarean rates among first-time, low risk mothers and improve outcomes for the mothers and their offspring.
Carlson NS, Corwin EJ, Hernandez TL, Holt E, Lowe NK, Hurt KJ. Association between provider type and cesarean birth in healthy nulliparous laboring women: A retrospective cohort study. Birth. 2018 Jan 31. PMID: 29388247
Researchers analyzed data from over 200 individuals with heart failure to better understand the relationship between heart failure symptoms, medication adherence, and cardiac event-free survival. The researchers assessed the frequency of heart failure symptoms, such as difficulty breathing (dyspnea) and ankle swelling in the past three months, and cardiac events (involving hospitalization and cardiac death). The study found that many heart failure patients were non-compliant with their medications, which was significantly associated with increased heart failure symptoms. Medication adherence was found to mediate the relationship between heart failure symptoms and cardiac event-free survival in heart failure. These findings highlight the importance of medication adherence in heart failure.
Wu JR, Moser DK. Medication Adherence Mediates the Relationship Between Heart Failure Symptoms and Cardiac Event-Free Survival in Patients With Heart Failure. J Cardiovasc Nurs. 2018 Jan/Feb;33(1):40-46. PMID: 28591004
In a study of the use of patient-directed music to reduce anxiety in individuals receiving ventilation support, the intervention was found to significantly reduce anxiety and lowered ICU care costs by over $2000 per patient versus usual care. This finding is significant in that it demonstrates a cost-effective alternative to pharmacologic interventions for reducing anxiety in mechanically ventilated patients.
Chlan LL, Heiderscheit A, Skaar DJ, Neidecker MV. Economic Evaluation of a Patient-Directed Music Intervention for ICU Patients Receiving Mechanical Ventilatory Support. Crit Care Med. 2018 May 4.. [Epub ahead of print] PMID: 29727366
In a study funded by NINR and others, advanced cancer patients with depressive symptoms who participated in two randomized control trials comparing the outcomes of early palliative care to delayed or usual care were found to benefit significantly from early palliative care. Those with higher levels of depressive symptoms were found to receive the greatest benefit and had lowered mortality rates. Further research is needed to determine what mechanisms are responsible for these changes.
Prescott AT, Hull JG, Dionne-Odom JN, Tosteson TD, Lyons KD, Li Z, Li Z, Dragnev KH, Hegel MT, Steinhauser KE, Ahles TA, Bakitas MA. The role of a palliative care intervention in moderating the relationship between depression and survival among individuals with advanced cancer. Health Psychol. 2017 Dec;36(12):1140-1146. PMID: 29048177