The University of Maryland School of Nursing’s (UMSON) Susan G. Dorsey, Ph.D., MS, RN, FAAN, a professor and chair of the school’s Department of Pain and Translational Symptom Science; Associate Professor Cynthia Renn, Ph.D., MS, RN, FAAN; and professor Barbara Resnick, Ph.D., RN, CRNP, FAANP, FAAN, the Sonya Ziporkin Gershowitz chair in gerontology and co-director of UMSON’s Biology and Behavior Across the Lifespan Organized Research Center, were awarded more than $5.4 million by the National Institutes of Health (NIH) to fund their research projects, university officials announced Friday.
Dorsey and Renn, with co-principal investigator Angela Renee Starkweather, Ph.D., have been awarded more than $3.1 million over five years to fund the research project Neurophysiological and Transcriptomic Predictors of Chronic Low Back Pain: Towards Precision Pain Management (NEAT Study). Resnick has been awarded more than $2.3 million over five years to fund the research project Testing the Efficacy of Function-Focused Care for Acute Care (FFC-AC-EIT) in Patients with Alzheimer’s Disease and Related Dementias.
One of the most common and costly chronic pain conditions is lower back pain, with as many as 39% of patients who experience an acute lower-back pain episode reporting chronic lower-back pain lasting more than three months and long-term disability lasting two or more years.
The NEAT Study seeks to understand the transition from acute to chronic lower-back pain, which will enable researchers to identify biomarkers early in the transition period and to provide new therapeutic targets (e.g., newly identified signaling receptors that could be blocked in the central nervous system) at critical windows of opportunity to prevent and/or better manage chronic lower-back pain.
The study will explore if differences in patients’ neurophysiology and gene expressions can be used to build a predictive model that will use lower-back pain to identify which patients might transition from acute to chronic pain.
Resnick’s research recognizes that older adults in assisted living settings are particularly at risk for a decline in function and physical health as are older adults with Alzheimer’s disease and related dementias who are hospitalized. These individuals, along with nursing home residents, are at increased risk for delirium, falls, behavioral symptoms, and longer lengths of stay when hospitalized.
Physical activity (e.g., mobility, bathing, dressing) has a positive impact on older adults, including prevention of functional decline, less pain, less delirium, fewer behavioral symptoms, fewer falls, shorter lengths of stay, and decreased unplanned hospital readmissions. Despite known benefits, physical activity is not routinely encouraged, and older patients in all care settings spend the majority of time sedentary.
To address this issue, Resnick developed the Function Focused Care (FFC) approach to care and an implementation approach using the social-ecological model, social cognitive theory, and the Evidence Integration Triangle (EIT) to manage behavioral symptoms associated with dementia across all care settings. FFC-AC-EIT involves a four-step approach in which nurses teach, cue, and help ensure that older adults engage in physical activity and that staff motivate them to do so during all care. With this recent NIH funding, Resnick will test the efficacy of FFC-AC-EIT at the patient level. She will also evaluate FFC-AC-EIT’s impact on policies and environments that facilitate function and physical activity by comparing hospital units exposed to FFC-AC- EIT versus those exposed to FFC education only. She will also evaluate the feasibility of using FFC-AC- EIT, based on treatment fidelity (e.g., delivery of the intervention, receipt of the intervention by staff and patients, enactment or performance of the new behaviors in real-world settings), relative costs, and cost savings.